Academic Journal

Early identification of patients at low risk of death after myocardial infarction and potentially suitable for early hospital discharge

التفاصيل البيبلوغرافية
العنوان: Early identification of patients at low risk of death after myocardial infarction and potentially suitable for early hospital discharge
المؤلفون: Parson, R W, Jamrozik, K D, Hobbs, M S T, Thompson, D L
بيانات النشر: BMJ Publishing Group Ltd
سنة النشر: 1994
المجموعة: HighWire Press (Stanford University)
مصطلحات موضوعية: PAPERS
الوصف: Objectives : To find (a) whether data available shortly after admission for acute myocardial infarction can provide a reliable prognostic indicator of survival at 28 days, and (b) whether such an indicator might be used to identify patients at low risk of death and suitable for early discharge. Design : Retrospective analysis of data collected on patients admitted to a coronary care unit for acute myocardial infarction. A validation sample was selected at random from these patients. Setting : Coronary care units in Perth, Western Australia. Subjects : 6746 patients aged under 65 and resident in the Perth Statistical Division who during 1984-92 were admitted to a coronary care unit with symptoms of myocardial infarction. Main outcome measures : Sensitivity and specificity of several models for predicting survival at 28 days after myocardial infarction, and detailed performance characteristics of a particular model. Results : Patients with a pulse rate of 100 beats/min or less, aged 60 or under, and with symptoms typical of myocardial infarction, no past history of myocardial infarction or diabetes, and no significant Q wave in the admission electrocardiogram had a very high chance of survival at 28 days (99.2%). These patients made up one third of all patients studied. Conclusion : The prognostic index identifies patients very soon after admission who are at low risk of death and potentially eligible for early discharge from hospital or the coronary care unit. Computing the index does not need complex cardiac investigations. Clinical implications Clinical implications Shortage of hospital beds indicates a need for identifying low risk patients after myocardial infarction Simple clinical data may be used that will not add to the cost of hospital care Up to one third of patients may be suitable for early discharge based on clinical indices A prospective study of early discharge based on these data is strongly recommended
نوع الوثيقة: text
وصف الملف: text/html
اللغة: English
Relation: http://www.bmj.com/cgi/content/short/308/6935/1006; http://dx.doi.org/10.1136/bmj.308.6935.1006
DOI: 10.1136/bmj.308.6935.1006
الاتاحة: http://www.bmj.com/cgi/content/short/308/6935/1006
https://doi.org/10.1136/bmj.308.6935.1006
Rights: Copyright (C) 1994, BMJ Publishing Group Ltd
رقم الانضمام: edsbas.27A68BEA
قاعدة البيانات: BASE
الوصف
DOI:10.1136/bmj.308.6935.1006