SAFETY AND FEASIBILITY OF EARLY DISCHARGE IN LOW-RISK ACUTE CORONARY SYNDROME PATIENTS: A SINGLE CENTER EXPERIENCE
Topic: Acute coronary syndromes | |
| Type: Presentation - doctors , Number in the programme: 329 | |
| Bauer D.1, Neuberg M.2, Hlatká M.1, Smitalová S.1, Berka V.1, Mihalovič M.1, Kozel M.1, Moťovská Z.1, Odvodyová D.1, Lašmanská S.1, Hrdličková A.1, Kníže T.1, Poledníková K.1, Trinh M.1, Ulman J.1, Toušek P.1 1 Kardiologická klinika, FNKV, 3.LF UK, Prague, 2 FNKV, Prague | |
Background:Patient´s risk stratification in acute coronary sydrome (ACS) is well established. Low-risk patients (LRP) identification may reduce the hospitalization time and costs without compromising their outcome Aim: To create and implement universal protocol for selection low-risk ACS patients after interventional treatment and to assess its safety.Methods:Based on retrospective analysis of 932 single-center ACS patients (from 10/2018 to 12/2020) we identified clinical and angiographic parameters associated with 30-day survival. When all 12 parameters with highest association were fulfilled, 100% survival rate in 30-days was shown. Thus, we created a simple, universal protocol for LRP with the ability of early discharge (48-72hours after admission) and implemented into clinical practice. This approach included proper education by experienced nurse prior hospital discharge.Result:Out of 1765 hospitalized ACS patients (7/2021-10/2023), 99 (5.6%) LRP were discharged from hospital within 72 hours. History of MI was present in 8 and stroke in 3 patients, 11 patients had previous PCI and non of these patients had history of heart failure. Data from Czech Statistical Office proved 100% survival rate for both 30day (n=95) and 1year (n=50), respectively. The telephone FU was completed in 91 patients within 30-day and in 38 patients in 1-year. In these patients rehospitalization occured in 1 (1.1%) patient within 30days and 6 (16%) patients within 1year. Average hospitalization time of LRP with MI (n=80) was 2.39 days (SD 0.78). Graph 1 shows average hospitalization time of LRP with MI before and after implementation of protocol (p=0.062). Conclusion:Selection of low-risk ACS patients treated by PCI is feasible and safe. Clinical protocols for early discharge can reduce hospitalization stay and costs and it is safe with 100% 30day and 1year survival rate. | |
