Patients 65 or older discharged from the hospital as early as 48 hours after stenting and balloon angioplasty following a major heart attack have similar outcomes as those who stay four-to-five days, provided there are no in-hospital complications. This finding was published in the Journal of the American College of Cardiology.
Using data from the ACC’s CathPCI Registry linked with Centers for Medicare and Medicaid Services (CMS) claims data, researchers reviewed records for 33,920 patients between Jan. 6, 2004, and Dec. 21, 2009.
The study found regional differences in length of stay. Patients in hospitals in the West and Midwest tended to have shorter hospital stays than those in the North and Southeast.
Researchers also noted a trend in shorter hospital stays over the course of the study for three patient groups: those discharged in fewer than three days, patients who had stays of four-to-five days, and patients who had stays longer than five days. There was no significant difference in death at 30 days or major adverse cardiac events between the two groups.
Patients with the longest stays, those more than five days, tended to be older, had more comorbidities, and had more extensive coronary vessel disease than patients with medium or short hospital stays.
Little was known about the small number of patients who were discharged early—the same day or after an overnight stay. This group had poorer 30-day clinical outcomes, perhaps indicating the need for appropriate inpatient monitoring after the procedure.