Dávid Bauer, Vojtech Berka, Marek Neuberg, Denisa Odvodyová, Ivana Maliničová, Silvie Lašmanská, Simona Smitalová, Petr Mašek, Viktor Kočka, Zuzana Moťovská, Martin Kozel, Karolína Bartošková, Petr Toušek
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Finally, we compared all low-risk MI patients prior to (October 2018 to July 2021, Group A) and after (July 2021 to October 2023, Group B) EDP implementation in terms of length of hospital stay and financial costs.</p><p><strong>Results: </strong>From July 2021 to September 2024, we selected 101 low-risk MI patients treated by percutaneous coronary intervention. There were 41.6% STEMI (n = 42). We report 100% survival at 30 days. Only a single death occurred in an average follow-up of 1.9 years (± 0.9). Discharge within 3 days was more often after EDP implementation, with the mean hospital stay of 4.7 days (95% CI = 4.4 to 4.9) and 4.2 days (95% CI = 4.0 to 4.4) in Group A and Group B, respectively, p = 0.053. Department-associated healthcare costs decreased from 2,105.4 euros (95% CI = 1,922.6 to 2,288.3) in Group A to 1,557.9 euros (95% CI = 1,428.5 to 1,946.1) in Group B, p = 0.016.</p><p><strong>Conclusion: </strong>Implementation of a simple, universal protocol for selecting low-risk MI patients is feasible, represents excellent mid-term safety, and is associated with a decrease in healthcare-associated costs during index hospitalization.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"581820"},"PeriodicalIF":2.8000,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075429/pdf/","citationCount":"0","resultStr":"{\"title\":\"Universal Early Discharge Protocol for Acute Myocardial Infarction: A Single-Center Prospective Validation.\",\"authors\":\"Dávid Bauer, Vojtech Berka, Marek Neuberg, Denisa Odvodyová, Ivana Maliničová, Silvie Lašmanská, Simona Smitalová, Petr Mašek, Viktor Kočka, Zuzana Moťovská, Martin Kozel, Karolína Bartošková, Petr Toušek\",\"doi\":\"10.2147/VHRM.S581820\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Selected low-risk myocardial infarction (MI) patients may be safely discharged within 72 hours. 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Discharge within 3 days was more often after EDP implementation, with the mean hospital stay of 4.7 days (95% CI = 4.4 to 4.9) and 4.2 days (95% CI = 4.0 to 4.4) in Group A and Group B, respectively, p = 0.053. Department-associated healthcare costs decreased from 2,105.4 euros (95% CI = 1,922.6 to 2,288.3) in Group A to 1,557.9 euros (95% CI = 1,428.5 to 1,946.1) in Group B, p = 0.016.</p><p><strong>Conclusion: </strong>Implementation of a simple, universal protocol for selecting low-risk MI patients is feasible, represents excellent mid-term safety, and is associated with a decrease in healthcare-associated costs during index hospitalization.</p>\",\"PeriodicalId\":23597,\"journal\":{\"name\":\"Vascular Health and Risk Management\",\"volume\":\"22 \",\"pages\":\"581820\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2026-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075429/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vascular Health and Risk Management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/VHRM.S581820\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2026/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vascular Health and Risk Management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/VHRM.S581820","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的：选定的低风险心肌梗死（MI）患者可以在72小时内安全出院。目的是前瞻性地验证先前创建的选择低风险心肌梗死患者的方案并评估其安全性。方法：我们之前提出了一种选择低风险急性冠状动脉综合征患者的早期出院方案（EDP）。我们于2021年7月实施了EDP，选定的患者在72小时内出院。生存状况由国家卫生和统计信息办公室核实。最后，我们比较了所有低风险心肌梗死患者在实施EDP之前（2018年10月至2021年7月，A组）和之后（2021年7月至2023年10月，B组）的住院时间和财务成本。结果：从2021年7月至2024年9月，我们选择101例经皮冠状动脉介入治疗的低危心肌梗死患者。STEMI患者占41.6% （n = 42）。我们报告30天存活率为100%。平均随访1.9年（±0.9年），仅发生一例死亡。实施EDP后3天内出院较多，A组和B组的平均住院时间分别为4.7天（95% CI = 4.4 ~ 4.9）和4.2天（95% CI = 4.0 ~ 4.4）， p = 0.053。与部门相关的医疗费用从A组的2,105.4欧元（95% CI = 1,922.6至2,288.3）降至B组的1,557.9欧元（95% CI = 1,428.5至1,946.1），p = 0.016。结论：采用一种简单、通用的方案来选择低风险心肌梗死患者是可行的，具有极好的中期安全性，并且与指数住院期间医疗保健相关费用的降低有关。
Universal Early Discharge Protocol for Acute Myocardial Infarction: A Single-Center Prospective Validation.
Background and aims: Selected low-risk myocardial infarction (MI) patients may be safely discharged within 72 hours. The aim was to prospectively validate a previously created protocol for selecting low-risk MI patients and to assess their safety.
Methods: We have previously proposed an early discharge protocol (EDP) for selecting low-risk acute coronary syndrome patients. We implemented EDP in July 2021 and selected patients were discharged within 72 hours. Survival was verified by the National Office of Health and Statistical Information. Finally, we compared all low-risk MI patients prior to (October 2018 to July 2021, Group A) and after (July 2021 to October 2023, Group B) EDP implementation in terms of length of hospital stay and financial costs.
Results: From July 2021 to September 2024, we selected 101 low-risk MI patients treated by percutaneous coronary intervention. There were 41.6% STEMI (n = 42). We report 100% survival at 30 days. Only a single death occurred in an average follow-up of 1.9 years (± 0.9). Discharge within 3 days was more often after EDP implementation, with the mean hospital stay of 4.7 days (95% CI = 4.4 to 4.9) and 4.2 days (95% CI = 4.0 to 4.4) in Group A and Group B, respectively, p = 0.053. Department-associated healthcare costs decreased from 2,105.4 euros (95% CI = 1,922.6 to 2,288.3) in Group A to 1,557.9 euros (95% CI = 1,428.5 to 1,946.1) in Group B, p = 0.016.
Conclusion: Implementation of a simple, universal protocol for selecting low-risk MI patients is feasible, represents excellent mid-term safety, and is associated with a decrease in healthcare-associated costs during index hospitalization.
期刊介绍：
An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.
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