Rathod, KS;
Comer, K;
Casey-Gillman, O;
Moore, L;
Mills, G;
Ferguson, G;
Antoniou, S;
... Jones, DA; + view all
(2021)
Early Hospital Discharge Following PCI for Patients With STEMI.
Journal of the American College of Cardiology
, 78
(25)
pp. 2550-2560.
10.1016/j.jacc.2021.09.1379.
Preview |
Text
Patel_24h discharge manuscript_final.pdf - Accepted Version Download (338kB) | Preview |
Abstract
Background: Regional heart attack services have improved clinical outcomes following ST-segment elevation myocardial infarction (STEMI) by facilitating early reperfusion by primary percutaneous coronary intervention (PCI). Early discharge after primary PCI is welcomed by patients and increases efficiency of health care. Objectives: This study aimed to assess the safety and feasibility of a novel early hospital discharge pathway for low-risk STEMI patients. Methods: Between March 2020 and June 2021, 600 patients who were deemed at low risk for early major adverse cardiovascular events (MACE) were selected for inclusion in the pathway and were successfully discharged in <48 hours. Patients were reviewed by a structured telephone follow-up at 48 hours after discharge by a cardiac rehabilitation nurse and underwent a virtual follow-up at 2, 6, and 8 weeks and at 3 months. Results: The median length of hospital stay was 24.6 hours (interquartile range [IQR]: 22.7-30.0 hours) (prepathway median: 65.9 hours [IQR: 48.1-120.2 hours]). After discharge, all patients were contacted, with none lost to follow-up. During median follow-up of 271 days (IQR: 88-318 days), there were 2 deaths (0.33%), both caused by coronavirus disease 2019 (>30 days after discharge), with 0% cardiovascular mortality and MACE rates of 1.2%. This finding compared favorably with a historical group of 700 patients meeting pathway criteria who remained in the hospital for >48 hours (>48-hour control group) (mortality, 0.7%; MACE, 1.9%) both in unadjusted and propensity-matched analyses. Conclusions: Selected low-risk patients can be discharged safely following successful primary PCI by using a pathway that is supported by a structured, multidisciplinary virtual follow-up schedule.
| Type: | Article |
|---|---|
| Title: | Early Hospital Discharge Following PCI for Patients With STEMI |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jacc.2021.09.1379 |
| Publisher version: | https://doi.org/10.1016/j.jacc.2021.09.1379 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Early discharge, primary PCI, STEMI |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10141668 |
Archive Staff Only
 |
View Item |
