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Temporal trends and prognostic impact of hospital length of three or less days in uncomplicated myocardial infarction after primary percutaneous coronary intervention in Spain

Session Poster Session 6

Speaker Berenice Caneiro

Event : ESC Congress 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : B Caneiro (Vigo,ES), E Abuassi (Vigo,ES), JL Bernal (Madrid,ES), S Raposeiras-Roubin (Vigo,ES), FJ Elola (Madrid,ES), C Fernandez (Vigo,ES), R J Cobas Paz (Vigo,ES), I Munoz Pousa (Vigo,ES), M Cespon Fernandez (Vigo,ES), L M Dominguez Rodriguez (Vigo,ES), P Dominguez Erquicia (Vigo,ES), S Fernandez Barbeira (Vigo,ES), M Castineiras (Vigo,ES), A Iniguez Romo (Vigo,ES)

Authors:
B. Caneiro1 , E. Abuassi1 , J.L. Bernal2 , S. Raposeiras-Roubin1 , F.J. Elola3 , C. Fernandez1 , R.J. Cobas Paz1 , I. Munoz Pousa1 , M. Cespon Fernandez1 , L.M. Dominguez Rodriguez1 , P. Dominguez Erquicia1 , S. Fernandez Barbeira1 , M. Castineiras1 , A. Iniguez Romo1 , 1Hospital Άlvaro Cunqueiro, Cardiology - Vigo - Spain , 2University Hospital 12 de Octubre, Control Service - Madrid - Spain , 3Spanish Cardiology Society - Madrid - Spain ,

Topic(s):
Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 3369

Introduction and objectives: There is scarce data on the safety of hospital stay length in uncomplicated ST- elevation myocardial infarction (STEMI). We studied the trends of the hospital stay and the safety of short (≤3 days) vs. long hospital stay, in Spain.

Methods: Using data from the Minimum Basic Data set of Spanish taxpayer-funded health system. We identified patients with uncomplicated STEMI undergoing coronary angioplasty and who were discharged alive. The mean length of stay was calculated by multilevel Poisson regression with mixed-effects, including patients from 2003–15. The effect of short stay on cardiac diseases readmissions at 30 days and 1 year was evaluated by multilevel logistic regression, including patients from 2003–14. Thirty-day and 1-year cardiac diseases risk-standardized readmissions and mortality rates (RSRRs and RSMRs), respectively, were also compared.

Results: The adjusted mean length of stay was significantly reduced (incidence rate ratio <1; p<0.001) for each year since 2003. The percentage of short stay increased from 14.3% in 2003 to 19.5% in 2015 (p<0.001). In none of the specified models short stay was statistically significant (p>0.05). The RSRRs at 30 days and 1 year as well as RSMRs at 30 days, did not differ significantly between groups. 1-year RSMRs was significantly higher in the short stay group, although probably without clinical significance (0.103% vs. 0.109%, p<0.001). See Table.

Conclusions: In Spain, short hospital stay increased significantly from 2003 to 2015 and seems a safety option in uncomplicated STEMI patients.

Diff mean of RSRRs and RSMRs at 30 days &#x0026; 1 year
Stay lengthNMeanStandard deviationp-value
RSRRs at 30-day≤3 days6,4862.5410.740.20
>3 days31,6512.5540.72
RSRRs at 1 year≤3 days6,4865.3061.220.42
>3 days31,6515.2921.14
RSMRs at 30-day≤3 days6,4860.1090.04<0.001
>3 days31,6510.1030.03
RSMRs at 1 year≤3 days6,4860.4290.130.25
>3 days31,6510.4270.13
RSRRs = risk-standardized readmission rates; RSMRs = risk-standardized readmission mortality rates.

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