Coronary care unit requirements of patients with acute myocardial infarction treated with or without thrombolytic therapy: a pilot study.

OBJECTIVE

To determine if patients with acute myocardial infarction who receive thrombolytic therapy require more nursing care hours and a longer length of stay in the coronary care unit than those patients with acute myocardial infarction who do not receive thrombolytic therapy.

DESIGN

Retrospective cohort study using the coronary care unit data base and patient classification records.

SETTING

Northeastern university-affiliated, community-based, cardiovascular tertiary care center.

PATIENTS

All patients admitted to the coronary care unit with a diagnosis of acute myocardial infarction were screened. Of these, 20 patients who also had a patient classification form completed were included in the study. Ten of these patients had received thrombolytic therapy and 10 had not. The patients were grouped according to treatment with a thrombolytic agent or conventional treatment. There was no significant difference in age between the groups (64 +/- 19 years and 67 +/- 15 years).

OUTCOME MEASURES

Nursing care hours per patient per day and length of stay per patient in the coronary care unit.

RESULTS

On days 1 and 2 of hospitalization, there were no significant differences in total nursing care hours provided per patient per day. On days 3 and 4, those patients who received thrombolytic therapy received fewer nursing care hours compared with those who did not (11.1 and 9.2 vs 13.8 and 12.7 hours per patient day, respectively; p < or = 0.05). Patients who were treated with thrombolytic therapy also had a significantly shorter coronary care unit stay (3.1 vs 4.0 days; p < or = 0.05).

CONCLUSION

In this retrospective, observational pilot study, patients who received thrombolytic therapy for treatment of acute myocardial infarction had a significantly shorter coronary care unit stay and required significantly less nursing care on days 3 and 4.