Poukkula A, Huhti E
Br Med J. 1980 Nov 1;281(6249):1170-2. doi: 10.1136/bmj.281.6249.1170.
Out of 368 patients admitted to hospital for chest pain and suspected acute myocardial infarction, 267 were discharged within 24 hours on the basis of the clinical picture, electrocardiogram, and serum activities of aspartate transaminase, alpha-hydroxybutyrate dehydrogenase, and creatine phosphokinase. The patients were followed up for 28 days, during which 17 were readmitted, two of them twice and one three times. Two of the patients were readmitted with non-fatal acute myocardial infarction, and two died. The patients had been primarily divided into two groups: those admitted with presumably non-coronary chest pain (77 patients) formed group 1 and those with obvious coronary chest pain (190 patients) group 2. Both deaths occurred in patients in group 2 but the incidences of events during the follow-up period were otherwise similar in the two groups, and some patients in both groups may have had small acute myocardial infarctions when first admitted. The decision to keep in hospital or discharge a patient with chest pain of recent onset can be made within 24 hours of admission. To discharge the patient acute myocardial infarction need not necessarily be excluded and conventional tests are enough to enable a decision to be made.
在因胸痛入院且疑似急性心肌梗死的368例患者中，267例根据临床表现、心电图以及天冬氨酸转氨酶、α-羟丁酸脱氢酶和肌酸磷酸激酶的血清活性，在24小时内出院。对这些患者进行了28天的随访，在此期间，17例患者再次入院，其中2例再次入院2次，1例再次入院3次。2例患者因非致命性急性心肌梗死再次入院，2例死亡。患者最初被分为两组：以可能的非冠状动脉性胸痛入院的患者（77例）为第1组，有明显冠状动脉性胸痛的患者（190例）为第2组。两例死亡均发生在第2组患者中，但两组随访期间的事件发生率在其他方面相似，两组中的一些患者在首次入院时可能有小面积急性心肌梗死。对于近期发作胸痛的患者，在入院24小时内即可决定是否留院或出院。不必排除急性心肌梗死患者出院，常规检查足以做出决定。
