Duration of Hospital Stay and Post- Myocardial Infarction Morbidity and Mortality: A Kaiser-Permanente Experience

Abstract

Among 209 evaluable consecutive patients (mean age 57 years) admitted in 1978 and 1979 for acute myocardial infarction, 186 survived. The mean hospital stay of the survivors was 9.7 days. Of these patients, 99 (53%) with complicated myocardial infarction had a mean hospital stay of 11.2 days; 87 (47%) with uncomplicated infarction had a mean stay of 7.9 days.

All patients were followed for at least 6 months. During the 6-month post- hospitalization interval, the overall mortality was about 6%. Of the 12 patients who died, 11 had complicated, and 1 had uncomplicated myocardial infarction.

The reinfarction rate in 6 months was 4% for complicated and 2% for uncomplicated infarction. Congestive heart failure was 3% for complicated and zero for uncomplicated infarction.

Comparing these findings with reported series of patients with longer hospitalizations, we found no evidence that shortened hospitalization ad versely affects mortality or morbidity.

Get full access to this article

View all access options for this article.

References

Wenger, N.K. , Hellerstein, H.K. , Blackburn, H. , et al.: Uncomplicated myocardial infarction: Current physician practice in patient management. J. Am. Med. Assoc., 224: 511, 1973.

Commission on Professional and Hospital Activities : Length in Stay in PAS Hospitals. Ann Arbor, MI, Commission on Professional and Hospital Activities, 1973 .

Hutter, A.M. , Jr., Sidel, V.W. , Shine, K.I. , et al.: Early hospital discharge after myocardial infarction. N. Engl. J. Med., 288: 1141, 1973 .

McNeer, J.F. , Wagner, G.S. , Ginsberg, P.B. , et al.: Hospital discharge one week after acute myocardial infarction. N. Engl. J. Med., 298: 229, 1978.

Ahlmark, G. , Ahlberg, G. Saetre, H. , et al.: A controlled study of early discharge after uncomplicated myocardial infarction. Acta Med. Scand., 206: 87, 1979.

Davis, H.T. , DeCamilla J. , Bayer, L.W. , et al.: Survivorship patterns in the posthospital phase of myocardial infarction. Circulation, 60: 1252, 1979.

Bigger, J.T. , Jr., Heller, C.A. , Wenger, T.L. , et al.: Risk stratification after acute myocardial infarction. Am. J. Cardiol., 42: 202, 1978.

McNeer, J.F. , Wallace, A.G. , Wagner, G.S. , et al.: The course of acute myocardial infarction: Feasibility of early discharge of the uncomplicated patient. Circulation, 51: 410, 1975.

Chaturvedi, N.C. , Walsh, M.J. , Evans, A. , et al.: Selection of patients for early discharge after acute myocardial infarction. Br. Heart J., 36: 533, 1974.

10.

Hill, J.D. , Hampton, J.R. , Mitchell, J.R.A. : Home or hospital for myocardial infarction—who cares? Am. Heart J., 98: 545, 1979.

11.

Mather, H.G. , Morgan, D.C. , Pearson, N.G. , et al.: Myocardial infarction: A comparison between home and hospital care for patients. Br. Med. J., 1: 925, 1976.

12.

Commission on Professional and Hospital Activities : Length of Stay in PAS Hospitals. Ann Arbor, MI, Commission on Professional and Hospital Activities, 1976.

13.

Commission on Professional and Hospital Activities : Length of Stay in PAS Hospitals. Ann Arbor, MI, Commission on Professional and Hospital Activities, 1980 .

14.

Schroeder, J.S. , Lamb, I.H. , Hu, M. : Do patients in whom myocardial infarction has been ruled out have a better prognosis after hospitalization than those surviving infarction? N. Engl. J. Med., 303: 1, 1980.

15.

Moss, A.J. , DeCamilla, J. , Davis, H. : Cardiac death in the first 6 months after myocardial infarction: Potential for mortality reduction in the early posthospital period. Am. J. Cardiol., 39: 816, 1977.

16.

Lie, K.I. , Liem, K.L. , Shuilenburg, R.M. , et al.: Early identification of patients developing late in-hospital ventricular fibrillation after discharge from the coronary care unit. Am. J. Cardiol., 41: 674, 1978.

17.

Kannel, W.B. , Sorlie, P. , McNamara, P.M. : Prognosis after initial myocardial infarction: The Framingham Study. Am. J. Cardiol., 44: 53, 1979.

18.

Moss, A.J. , DeCamilla, J. , Davis, H. , et al.: The early posthospital phase of myocardial infarction: Prognostic stratification. Circulation, 54: 58, 1976.

19.

Goldberg, R. , Szklo, M. , Tonascia, J.A. , et al.: Time trends in prognosis of patients with myocardial infarction: A population-based study. Johns Hopkins Med. J., 144: 73, 1979.