PMID- 31264471
OWN - NLM
STAT- MEDLINE
DCOM- 20200818
LR  - 20220414
IS  - 2048-8734 (Electronic)
IS  - 2048-8726 (Linking)
VI  - 8
IP  - 6
DP  - 2019 Sep
TI  - Current perspectives on location of monitoring and length of stay following PPCI 
      for ST elevation myocardial infarction.
PG  - 562-570
LID - 10.1177/2048872619860217 [doi]
AB  - IMPORTANCE: There is marked variability in location of care and hospital length 
      of stay after primary percutaneous coronary intervention for ST elevation 
      myocardial infarction (STEMI). OBSERVATIONS: We performed a literature review on 
      non-critical care monitoring and early discharge following primary percutaneous 
      coronary intervention and describe a framework for implementation in the real 
      world. The medical literature was searched from 1 January 1988 to 31 April 2019 
      using PubMed and Cochrane Central Register of Controlled Trials. Randomized 
      clinical trials, observational studies and guideline statements were included. 
      Available data suggest that carefully selected low-risk STEMI patients identified 
      using Zwolle or CADILLAC risk stratification scores after primary percutaneous 
      coronary intervention may be considered for discharge after 48 hours of hospital 
      care. There was no increase in major adverse cardiac events, medication 
      non-compliance or hospital readmission with this treatment strategy. There are 
      limited data on non-critical monitoring of uncomplicated STEMI patients; however, 
      given the low adverse events rate, this strategy is likely to be safe in selected 
      patients and may facilitate reduced length of stay and reduce resource 
      utilization. CONCLUSIONS AND RELEVANCE: Available evidence supports the safety of 
      early discharge after 48 hours of care and omission of critical care monitoring 
      in carefully selected patients following primary percutaneous coronary 
      intervention. Early risk stratification and structured discharge planning are 
      imperative. Adoption of this treatment strategy could reduce hospital costs, 
      resource utilization and enhance patient satisfaction without affecting outcomes.
FAU - Sharkawi, Musa A
AU  - Sharkawi MA
AD  - Heart and Vascular Institute, Hartford HealthCare, USA.
AD  - University of Connecticut, School of Medicine, USA.
FAU - McMahon, Sean
AU  - McMahon S
AD  - Heart and Vascular Institute, Hartford HealthCare, USA.
AD  - University of Connecticut, School of Medicine, USA.
FAU - Al Jabri, Dania
AU  - Al Jabri D
AD  - University of Connecticut, School of Medicine, USA.
FAU - Thompson, Paul D
AU  - Thompson PD
AD  - Heart and Vascular Institute, Hartford HealthCare, USA.
AD  - University of Connecticut, School of Medicine, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190702
PL  - England
TA  - Eur Heart J Acute Cardiovasc Care
JT  - European heart journal. Acute cardiovascular care
JID - 101591369
SB  - IM
MH  - Aged
MH  - Coronary Care Units/standards/statistics & numerical data
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic/*methods/trends
MH  - Observational Studies as Topic
MH  - Patient Discharge/*trends
MH  - Patient Readmission/statistics & numerical data
MH  - Patient Satisfaction/statistics & numerical data
MH  - Percutaneous Coronary Intervention/*methods
MH  - Randomized Controlled Trials as Topic
MH  - Risk Assessment
MH  - ST Elevation Myocardial Infarction/epidemiology/*therapy
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Length of stay
OT  - STEMI
OT  - coronary care unit
OT  - primary PCI
EDAT- 2019/07/03 06:00
MHDA- 2020/08/19 06:00
CRDT- 2019/07/03 06:00
PHST- 2019/07/03 06:00 [pubmed]
PHST- 2020/08/19 06:00 [medline]
PHST- 2019/07/03 06:00 [entrez]
AID - 10.1177/2048872619860217 [doi]
PST - ppublish
SO  - Eur Heart J Acute Cardiovasc Care. 2019 Sep;8(6):562-570. doi: 
      10.1177/2048872619860217. Epub 2019 Jul 2.