Rymer JA, et al. - Researchers wanted to determine the relationship between discharge timing and post-discharge outcomes in non-ST-segment elevation myocardial infarction (NSTEMI) patients. The risk of subsequent short- and intermediate-term death or ischemic events was found to be low among NSTEMI patients without serious complications during the first 2 hospital days.

Methods

• Using landmark analyses, in which the landmark defined potential days of discharge, researchers estimated complication rates on the first day the patient would have been out of the hospital.
• They also examined links between timing of discharge and 30-day and 1-year event free survival post-discharge.

Results

• A total of 20,410 NSTEMI patients were included with a median LOS of 7 (4, 12) days reported.
• On days 0-2, a cardiac complication was reported in 3,209 (15.7%).
• During hospital days 0-2, 1,322 (6.5%) were discharged without complications.
• Hospitalization continued for 15,879 patients (77.8%) without complications at the start of day 3.
• Of these, 1,689 (10.6%) were discharged event-free on Day 3.
• Adjusted event-free survival rates of death or MI from Day 4 to Day 30 was 99.1% vs 93.1% for these 1,689 patients and the 14,190 who remained hospitalized at the end of Day 3, respectively, and 98.1% and 96.4%, respectively, for 1-year mortality.
• At the start of day 4, 13,334 patients were still hospitalized with no complications, and 1,706 of them were discharged event-free that day.
• For these patients discharged on Day 4 vs those still hospitalized at the end of Day 4, the adjusted survival rates were 98.0% vs 93.7% for 30-day death or MI and 97.8% vs 96.1% for 1-year mortality.