SAFETY AND FEASIBILITY OF EARLY DISCHARGE IN LOW-RISK ACUTE CORONARY SYNDROME PATIENTS: A SINGLE CENTER EXPERIENCE

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.