Short hospital stay after heart attack can be safe

Contrary to expectations, the decreases in length of hospital stay for heart attacks seen over the last two decades have not increased death rates after discharge, according to a report in the American Journal of Cardiology. In fact, just the opposite may be true.

Using data from the Minnesota Heart Survey, Dr. Alan K. Berger from the University of Minnesota, Minneapolis, and colleagues found the typical hospital length of stay decreased progressively from 9 days in 1985 to 4 days in 2001; at the same time, in-hospital deaths after heart attack were decreasing from 11.6 to 5.4 percent.

"There was a significant decrease in both 1-month and 6-month (death) rates after discharge from 1985 to 2001," the researchers report.

Thirty-day death rates tended to be lower for patients discharged early, the investigators say, and rates at 6 months were slightly higher among patients staying in the hospital 5 or more days after their heart attack.

Patients discharged from the hospital early were more likely to undergo angioplasty during their hospitalizations, the researchers note, whereas patients discharged later were more likely to undergo heart bypass surgery.

"Physicians should utilize standard guidelines and protocols to determine which patients would benefit from additional hospitalization and procedures," Berger said.

SOURCE: American Journal of Cardiology, February 15, 2008.