Clinical research studyDeclining Length of Stay for Patients Hospitalized with AMI: Impact on Mortality and Readmissions
Section snippets
Methods
Data for this study were derived from the Worcester Heart Attack Study.11, 12, 13 This is an ongoing population-based investigation that is examining long-term trends in the incidence, hospital, and postdischarge case-fatality rates of acute myocardial infarction among residents of the Worcester (MA) metropolitan area hospitalized at all area medical centers. The details of this study have been described previously.12, 13 In brief, the medical records of area residents (2000 census estimate =
Length of Hospital Stay
There have been marked changes in the distribution of length of stay for greater Worcester residents hospitalized with acute myocardial infarction during the period under study (1995-2005) (Figure). The average length of stay decreased by more than 2 days over the 10-year study period from 7.2 days in 1995 to 5.0 days in 2005, corresponding to a 30% overall decrease in length of stay over this period. In 1995, <20% of patients were hospitalized for <5 days compared with approximately 60% of
Discussion
The results of this population-based observational study suggest that the average length of stay in patients hospitalized with validated acute myocardial infarction in a large New England community decreased between 1995 and 2005. Additionally, we found that shorter lengths of stay did not adversely affect the risk of hospital readmission 7 and 30 days after hospital discharge or mortality in the 30 and 90 days following discharge.
A number of studies have shown that, despite the advanced age
Conclusions
New classifications of patients at low risk for poor outcomes (eg, uncomplicated acute myocardial infarction) may help identify patients who may benefit from early hospital discharge.23 The results of this population-based study show that shorter hospital stays are not associated with higher rates of rehospitalization or of postdischarge mortality. However, further studies are needed to identify the optimal length of hospital stay for patients who have experienced an acute myocardial infarction.
Acknowledgment
This research was made possible by the cooperation of participating hospitals in the Worcester metropolitan area and through funding provided by the National Institutes of Health (RO1 HL35434).
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Funding: This research was funded by the National Institutes of Health (RO1 HL35434).
Conflict of Interest: The authors have no conflicts of interest to report.
Authorship: All authors had access to the data and a role in writing the manuscript.