Węgiel Michał, Dziewierz Artur, Wojtasik-Bakalarz Joanna, Sorysz Danuta, Surdacki Andrzej, Bartuś Stanisław, Dudek Dariusz, Rakowski Tomasz
2nd Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, 31-501 Krakow, Poland.
Institute of Cardiology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
J Clin Med. 2018 Dec 18;7(12):564. doi: 10.3390/jcm7120564.
According to guidelines, it is safe for low-risk patients with myocardial infarction (MI) to be discharged within 72 h of hospitalization. However, results coming from registries show that the hospital stay is often much longer in a real-life situation. Data on the length of the hospital stay (LOS) of MI patients in Polish centers are lacking. We enrolled 212 consecutive patients with acute MI. Low-risk patients were defined according to PAMI II criteria: age <70 years, left ventricular ejection fraction (LVEF) >45%, no persistent ventricular arrhythmia, and no multi-vessel disease (MVD). The median of the hospitalization length was eight days (Q1: 6; Q3: 9). In low-risk patients (25%), the median of LOS was six days (Q1: 5; Q3: 7) ( < 0.001). In a logistic regression analysis patients age, LVEF, ST-segment-elevation MI and the presence of MVD were independent predictors of longer hospitals stay (≥8 days). During follow up, there were no significant differences in the rates of clinical events between patients with shorter (<8 days) and longer (≥8 days) hospitalization. In a real-life situation, the LOS, even in low-risk patients is much longer than recommended in the guidelines.
根据指南，心肌梗死（MI）低风险患者在住院72小时内出院是安全的。然而，登记处的数据显示，在现实生活中，住院时间往往长得多。波兰各中心缺乏关于MI患者住院时间（LOS）的数据。我们纳入了212例连续的急性MI患者。低风险患者根据PAMI II标准定义：年龄<70岁、左心室射血分数（LVEF）>45%、无持续性室性心律失常且无多支血管病变（MVD）。住院时间的中位数为8天（第一四分位数：6；第三四分位数：9）。在低风险患者（25%）中，LOS的中位数为6天（第一四分位数：5；第三四分位数：7）（<0.001）。在逻辑回归分析中，患者年龄、LVEF、ST段抬高型MI以及MVD的存在是住院时间较长（≥8天）的独立预测因素。在随访期间，住院时间较短（<8天）和较长（≥8天）的患者之间临床事件发生率没有显著差异。在现实生活中，即使是低风险患者，LOS也比指南中建议的长得多。
