Discharge Policy and Reperfusion Therapy in Acute Myocardial Infarction
Year: 2007
Type: dissertation
Abstract: Treatment of patients with acute myocardial \ninfarction (MI) has improved over time and the duration of hospital \nstay has considerably decreased. Early hospital discharge after MI \nhas been promoted for over 25 years. However, the meaning of “early” \nevolved over time. In the early eighties, before the widespread \nintroduction of reperfusion therapy, patients were hospitalised for \napproximately 3 weeks and early discharge implemented a reduction to \n7 days. Nowadays, the average hospital stay in the Netherlands \namounts up to 8 days and “early” discharge is after 3-5 days. \nEvidently, in a cost-conscious environment hospitalisation should not \nbe extended beyond the patient’s clinical needs. Still, evidence \nexists that further reduction in length of hospital stay can be \nachieved compared to current practice. In particular, after primary \nPCI that nowadays is the choice of reperfusion therapy especially in \nthe Netherlands, when coronary anatomy and left ve!\n ntricular function are known, discharge can be safely effectuated \nafter a few days. In particular, because early hospital discharge has \nbeen associated with improved physical and psychological outcome, \nespecially in elderly subjects.\nWe developed and validated different early discharge strategies in \nunselected patients with acute myocardial infarction in different \npatient cohorts. Over time reperfusion therapy changed and we \nevaluated the consequences for discharge policy and validated our \nallocation model of reperfusion therapy with 10 years of follow-up. \nFurthermore, we investigated the psychological impact of early \ndischarge.
Author: Maureen van der Vlugt
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2119843308