Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Bhat, Anusha G., Singh, Mandeep, Patlolla, Sri Harsha, Belford, Peter Matthew, Zhao, David X., Vallabhajosyula, Saraschandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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
_version_ 1784856960705757184
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
work_keys_str_mv AT bhatanushag hospitalizationdurationforacutemyocardialinfarctionatemporalanalysisof18yearunitedstatesdata
AT singhmandeep hospitalizationdurationforacutemyocardialinfarctionatemporalanalysisof18yearunitedstatesdata
AT patlollasriharsha hospitalizationdurationforacutemyocardialinfarctionatemporalanalysisof18yearunitedstatesdata
AT belfordpetermatthew hospitalizationdurationforacutemyocardialinfarctionatemporalanalysisof18yearunitedstatesdata
AT zhaodavidx hospitalizationdurationforacutemyocardialinfarctionatemporalanalysisof18yearunitedstatesdata
AT vallabhajosyulasaraschandra hospitalizationdurationforacutemyocardialinfarctionatemporalanalysisof18yearunitedstatesdata