Predictors of length of hospital stay after acute myocardial infarction in Japan
Predictors of length of hospital stay after acute myocardial infarction in Japan
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DOI：
10.1253/circj.68.809
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发表时间：
2004-09-01
影响因子：
3.3
通讯作者：
Hori, M
中科院分区：
文献类型：
--
作者：
Kinjo, K;Sato, H;Hori, M
背景在西方国家，急性心肌梗死(AMI)后的住院时间在过去的30年里急剧减少，现在大约为1周。然而，在日本，关于住院时间、其预测因素和基于大规模样本的趋势的流行病学数据仍然有限。方法和结果研究组包括1998年4月至2003年3月参加大阪急性冠脉功能不全研究的4,113名存活的急性心肌梗死患者。平均住院天数为31.2天。临床因素(患者特征、梗塞严重程度、治疗和住院并发症)仅能解释住院天数变化的26%。1998年的平均住院时间明显长于2002年。2002年，职业状况和进入大流量医院是住院时间较短的独立预测因素，但在1998年没有观察到这种关联。结论日本的住院时间仍然很长，临床因素不能提供解释。本研究的结果表明，一些急性心肌梗死患者的住院时间可以减少，但需要进行随机研究来检验提前出院的可行性。
Background In Western countries, the length of hospital stay after acute myocardial infarction (AMI) has decreased dramatically during the past 3 decades and is now approximately 1 week. However, epidemiological data concerning the length of hospital stay, its predictors and trends based on a large-scale sample are still limited in Japan.Methods and Results The study group comprised 4,113 surviving AMI patients who were enrolled in the Osaka Acute Coronary Insufficiency Study from April 1998 to March 2003. The mean length of hospital stay was 31.2 days. Clinical factors (patient characteristics, severity of infarction, therapy, and in-hospital complications) only explained 26% of the variation in hospital stay. The mean hospital stay was significantly longer in 1998 than in 2002. In 2002, occupational status and admission to a high-volume hospital were independent predictors of a shorter hospital stay, but this association was not observed in 1998.Conclusions The hospital stay is still extremely long in Japan and clinical factors do not provide an explanation. The findings of the present study suggest that the hospital stay could be reduced in some patients with AMI, but randomized studies are needed to examine the feasibility of early discharge.