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对低风险ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗后早期出院方法的探索。

An exploration of the early discharge approach for low-risk STEMI patients following primary percutaneous coronary intervention.

作者信息

Broughton Nicole, Comer Katrina, Casey-Gillman Oliver, Moore Lizze, Antoniou Sotiris, Patel Riyaz, Fhadil Sadeer, Wright Paul, Ozkor Muhiddin, Guttmann Oliver, Baumbach Andreas, Wragg Andrew, Jain Ajay J, Choudry Fizzah, Mathur Anthony, Rathod Krishnaraj S, Jones Daniel A

机构信息

Centre for Cardiovascular Medicine and Devices, Willian Harvey Research Institute, Queen Mary University of London London EC1A 7BE, UK.

Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust London EC1A 7BE, UK.

出版信息

Am J Cardiovasc Dis. 2023 Apr 15;13(2):32-42. eCollection 2023.

Abstract

Recently, there has been growing interest in the early discharge strategy for low-risk patients who have undergone primary percutaneous coronary intervention (PCI) to treat ST-segment elevation myocardial infarction (STEMI). So far findings have suggested there are multiple advantages of shorter hospital stays, including that it could be a safe way to be more cost- and resource-efficient, reduce cases of hospital-acquired infection and boost patient satisfaction. However, there are remaining concerns surrounding safety, patient education, adequate follow-up and the generalisability of the findings from current studies which are mostly small-scale. By assessing the current research, we describe the advantages, disadvantages and challenges of early hospital discharge for STEMI and discuss the factors that determine if a patient can be considered low risk. If it is feasible to safely employ a strategy like this, the implications for healthcare systems worldwide could be extremely beneficial, particularly in lower-income economies and when we consider the detrimental impacts of the recent COVID-19 pandemic on healthcare systems.

摘要

最近,对于接受了直接经皮冠状动脉介入治疗(PCI)以治疗ST段抬高型心肌梗死(STEMI)的低风险患者,早期出院策略越来越受到关注。到目前为止,研究结果表明缩短住院时间有多种好处,包括这可能是一种更具成本效益和资源效率的安全方式,可减少医院获得性感染病例并提高患者满意度。然而,围绕安全性、患者教育、充分的随访以及当前大多为小规模研究结果的普遍性仍存在担忧。通过评估当前的研究,我们描述了STEMI患者早期出院的优点、缺点和挑战,并讨论了决定患者是否可被视为低风险的因素。如果安全采用这样的策略是可行的,那么对全球医疗系统的影响可能极其有益,特别是在低收入经济体中,以及当我们考虑近期COVID-19大流行对医疗系统的不利影响时。

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A Novel Protocol for Very Early Hospital Discharge After STEMI.急性 ST 段抬高型心肌梗死患者非常早期出院的新方案。
Can J Cardiol. 2020 Nov;36(11):1826-1829. doi: 10.1016/j.cjca.2020.08.012. Epub 2020 Aug 22.

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