EARLY DISCHARGE IN SELECTED ACUTE CORONARY SYNDROME PATIENTS AFTER INTERVENTIONAL TREATMENT: A SINGLE CENTER EXPERIENCE (YOUNG INVESTIGATOR AWARD COMPETITION)
Topic: Acute coronary syndromes | |
Type: Presentation - doctors , Number in the programme: 4 | |
Enlisted in: Young investigator awards | |
Bauer D.1, Smitalová S.1, Neuberg M.2, Hlatká M.1, Moťovská Z.3, Kozel M.4, Toušek P.1 1 Kardiologická klinika, FNKV, 3.LF UK, Prague, 2 FNKV, Prague, 3 III. interní-kardiologická klinika, 3. lékařská fakulta Univerzity Karlovy v Praze a Fakultní nemocnice Královské Vinohrady, Praha, 4 III. interní-kardiologická klinika, FNKV, Praha | |
Background: Utility of risk stratification in acute coronary sydrome (ACS) patients is well established. Efficient identification of low-risk patients may reduce the hospitalization time without compromising their prognosis. Aim: To create and implement universal protocol for selection low-risk ACS patients after interventional treatment. Methods: Based on retrospective analysis of 932 single-center ACS patients (from 10/2018 to 12/2020) we identified several parametrs highly associated to 30-day survival. Unifying these parameters showed (retrospectively) ability to select low-risk ACS patients with 100% survival rate in 30-days. We created a simple, universal protokol and implemented into clinical practice. Prior hospital discharge a proper education by experienced nurse was perfomed. Results: In 2year period (7/2021–7/2023) we selected 98 low-risk ACS patients and discharged from hospital within 72 hours. In 89 patients telephone follow-up was completed at 30-day with 100% survival rate. Currently, in 39 patients (39%) 1-year follow-up was completed, 5.1% (n=2) had history of CABG and 10.3% (n=4) history of MI. 64% (n=25) were men and 82% (n=32) presented with MI (STEMI in 25.6%, n=10). Rehospitalization occured in 15.3% (n=6). All patients had 100% survival rate in 1 year after ACS. We compared hospitalization time of low-risk ACS patients in 1 year period before (10/2018 - 10/2019, group A, n=86) and after (7/2021 - 7/2022, group B, n=60) implementation of protocol into clinical practice. Median hospitalization time in Group A was 2 days compared to 1 day in Group B, p=0.467, in MI patients median was 4 days in group A (n=51) and 3 days in group B (n=36), p=0.062. Conclusion: Selection of low-risk ACS patient treated by PCI is feasible and safe. Proper protocols can reduce hospitalization stay and may reach 100% 30-day and 1-year survival rate | |