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Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data
Background and objectives: Primary percutaneous coronary intervention (PCI)-related outcomes in acute myocardial infarction (AMI) have improved over time, but there are limited data on the length of stay (LOS) in relation to in-hospital mortality. Materials and Methods: A retrospective cohort of adu...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780977/ https://www.ncbi.nlm.nih.gov/pubmed/36557048 http://dx.doi.org/10.3390/medicina58121846 |
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author | Bhat, Anusha G. Singh, Mandeep Patlolla, Sri Harsha Belford, Peter Matthew Zhao, David X. Vallabhajosyula, Saraschandra |
author_facet | Bhat, Anusha G. Singh, Mandeep Patlolla, Sri Harsha Belford, Peter Matthew Zhao, David X. Vallabhajosyula, Saraschandra |
author_sort | Bhat, Anusha G. |
collection | PubMed |
description | Background and objectives: Primary percutaneous coronary intervention (PCI)-related outcomes in acute myocardial infarction (AMI) have improved over time, but there are limited data on the length of stay (LOS) in relation to in-hospital mortality. Materials and Methods: A retrospective cohort of adult AMI admissions was identified from the National Inpatient Sample (2000–2017) and stratified into short (≤3 days) and long (>3 days) LOS. Outcomes of interest included temporal trends in LOS and associated in-hospital mortality, further sub-stratified based on demographics and comorbidities. Results: A total 11,622,528 admissions with AMI were identified, with a median LOS of 3 (interquartile range [IQR] 2–6) days with 49.9% short and 47.3% long LOS, respectively. In 2017, compared to 2000, temporal trends in LOS declined in all AMI, with marginal increases in LOS >3 days and decreases for ≤3 days (median 2 [IQR 1–3]) vs. long LOS (median 6 [IQR 5–9]). Patients with long LOS had lower rates of coronary angiography and PCI, but higher rates of non-cardiac organ support (respiratory and renal) and use of coronary artery bypass grafting. Unadjusted in-hospital mortality declined over time. Short LOS had comparable mortality to long LOS (51.3% vs. 48.6%) (p = 0.13); however, adjusted in-hospital mortality was higher in LOS >3 days when compared to LOS ≤ 3 days (adjusted OR 3.00, 95% CI 2.98–3.02, p < 0.001), with higher hospitalization (p < 0.001) when compared to long LOS. Conclusions: Median LOS in AMI, particularly in STEMI, has declined over the last two decades with a consistent trend in subgroup analysis. Longer LOS is associated with higher in-hospital mortality, higher hospitalization costs, and less frequent discharges to home compared to those with shorter LOS. |
format | Online Article Text |
id | pubmed-9780977 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97809772022-12-24 Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data Bhat, Anusha G. Singh, Mandeep Patlolla, Sri Harsha Belford, Peter Matthew Zhao, David X. Vallabhajosyula, Saraschandra Medicina (Kaunas) Article Background and objectives: Primary percutaneous coronary intervention (PCI)-related outcomes in acute myocardial infarction (AMI) have improved over time, but there are limited data on the length of stay (LOS) in relation to in-hospital mortality. Materials and Methods: A retrospective cohort of adult AMI admissions was identified from the National Inpatient Sample (2000–2017) and stratified into short (≤3 days) and long (>3 days) LOS. Outcomes of interest included temporal trends in LOS and associated in-hospital mortality, further sub-stratified based on demographics and comorbidities. Results: A total 11,622,528 admissions with AMI were identified, with a median LOS of 3 (interquartile range [IQR] 2–6) days with 49.9% short and 47.3% long LOS, respectively. In 2017, compared to 2000, temporal trends in LOS declined in all AMI, with marginal increases in LOS >3 days and decreases for ≤3 days (median 2 [IQR 1–3]) vs. long LOS (median 6 [IQR 5–9]). Patients with long LOS had lower rates of coronary angiography and PCI, but higher rates of non-cardiac organ support (respiratory and renal) and use of coronary artery bypass grafting. Unadjusted in-hospital mortality declined over time. Short LOS had comparable mortality to long LOS (51.3% vs. 48.6%) (p = 0.13); however, adjusted in-hospital mortality was higher in LOS >3 days when compared to LOS ≤ 3 days (adjusted OR 3.00, 95% CI 2.98–3.02, p < 0.001), with higher hospitalization (p < 0.001) when compared to long LOS. Conclusions: Median LOS in AMI, particularly in STEMI, has declined over the last two decades with a consistent trend in subgroup analysis. Longer LOS is associated with higher in-hospital mortality, higher hospitalization costs, and less frequent discharges to home compared to those with shorter LOS. MDPI 2022-12-15 /pmc/articles/PMC9780977/ /pubmed/36557048 http://dx.doi.org/10.3390/medicina58121846 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Bhat, Anusha G. Singh, Mandeep Patlolla, Sri Harsha Belford, Peter Matthew Zhao, David X. Vallabhajosyula, Saraschandra Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data |
title | Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data |
title_full | Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data |
title_fullStr | Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data |
title_full_unstemmed | Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data |
title_short | Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data |
title_sort | hospitalization duration for acute myocardial infarction: a temporal analysis of 18-year united states data |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780977/ https://www.ncbi.nlm.nih.gov/pubmed/36557048 http://dx.doi.org/10.3390/medicina58121846 |
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