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Article

Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data

by
Anusha G. Bhat
1,†,
Mandeep Singh
2,†,
Sri Harsha Patlolla
3,
Peter Matthew Belford
4,
David X. Zhao
4 and
Saraschandra Vallabhajosyula
4,*
1
Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
2
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55901, USA
3
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55901, USA
4
Section of Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Medicina 2022, 58(12), 1846; https://doi.org/10.3390/medicina58121846
Submission received: 25 November 2022 / Revised: 8 December 2022 / Accepted: 14 December 2022 / Published: 15 December 2022
(This article belongs to the Special Issue Clinical Studies, Big Data, and Artificial Intelligence in Medicine)

Abstract

Background and objectives: Primary percutaneous coronary intervention (PCI)-related outcomes in acute myocardial infarction (AMI) have improved over time, but there are limited data on the length of stay (LOS) in relation to in-hospital mortality. Materials and Methods: A retrospective cohort of adult AMI admissions was identified from the National Inpatient Sample (2000–2017) and stratified into short (≤3 days) and long (>3 days) LOS. Outcomes of interest included temporal trends in LOS and associated in-hospital mortality, further sub-stratified based on demographics and comorbidities. Results: A total 11,622,528 admissions with AMI were identified, with a median LOS of 3 (interquartile range [IQR] 2–6) days with 49.9% short and 47.3% long LOS, respectively. In 2017, compared to 2000, temporal trends in LOS declined in all AMI, with marginal increases in LOS >3 days and decreases for ≤3 days (median 2 [IQR 1–3]) vs. long LOS (median 6 [IQR 5–9]). Patients with long LOS had lower rates of coronary angiography and PCI, but higher rates of non-cardiac organ support (respiratory and renal) and use of coronary artery bypass grafting. Unadjusted in-hospital mortality declined over time. Short LOS had comparable mortality to long LOS (51.3% vs. 48.6%) (p = 0.13); however, adjusted in-hospital mortality was higher in LOS >3 days when compared to LOS ≤ 3 days (adjusted OR 3.00, 95% CI 2.98–3.02, p < 0.001), with higher hospitalization (p < 0.001) when compared to long LOS. Conclusions: Median LOS in AMI, particularly in STEMI, has declined over the last two decades with a consistent trend in subgroup analysis. Longer LOS is associated with higher in-hospital mortality, higher hospitalization costs, and less frequent discharges to home compared to those with shorter LOS.
Keywords: length of stay; acute myocardial infarction; hospital stay; resource utilization; outcomes length of stay; acute myocardial infarction; hospital stay; resource utilization; outcomes

Share and Cite

MDPI and ACS Style

Bhat, A.G.; Singh, M.; Patlolla, S.H.; Belford, P.M.; Zhao, D.X.; Vallabhajosyula, S. Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data. Medicina 2022, 58, 1846. https://doi.org/10.3390/medicina58121846

AMA Style

Bhat AG, Singh M, Patlolla SH, Belford PM, Zhao DX, Vallabhajosyula S. Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data. Medicina. 2022; 58(12):1846. https://doi.org/10.3390/medicina58121846

Chicago/Turabian Style

Bhat, Anusha G., Mandeep Singh, Sri Harsha Patlolla, Peter Matthew Belford, David X. Zhao, and Saraschandra Vallabhajosyula. 2022. "Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data" Medicina 58, no. 12: 1846. https://doi.org/10.3390/medicina58121846

APA Style

Bhat, A. G., Singh, M., Patlolla, S. H., Belford, P. M., Zhao, D. X., & Vallabhajosyula, S. (2022). Hospitalization Duration for Acute Myocardial Infarction: A Temporal Analysis of 18-Year United States Data. Medicina, 58(12), 1846. https://doi.org/10.3390/medicina58121846

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