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Three Days in Hospital Enough for Some Heart Attack Patients?

By
WebMD Health News

March 15, 2000 (Washington) -- Many people who have a heart attack can safely return home after just three days in the hospital, as long as they don't have other serious problems, according to a study in the March 16 issue of TheNew England Journal of Medicine. Serious problems that could preclude such a short stay range from having a stroke or second heart attack to abnormal heart beats.

But hospitals and physicians first must make sure that everything was done right in the hospital and that the patient and his or her family are sufficiently prepared to cope once they leave, the lead author tells WebMD.

"We are not endorsing or saying in this study that we think patients should go home after three days," says L. Kristin Newby, MD. "What we are saying is, here is an opportunity. Almost 60% of heart attacks are uncomplicated. [But] most hospitals and physicians can't provide all the high-quality, evidence-based care in that shortened time frame. While it does look like an exciting opportunity, we are probably not there yet in terms of delivery." Newby is an assistant professor in the division of cardiology at Duke University School of Medicine in Durham, N.C.

"I don't think this is dramatic news and I don't think there will be much of a fight over this, " says cardiologist Allen J. Solomon, MD, an associate professor of medicine at Georgetown University in Washington. "It doesn't necessarily apply to all other patients. Now, if the evening news says you only need to stay three days for a heart attack, and it is not presented as [being] appropriate for a subset of patients who are doing extraordinarily well, then there could be a fight." Solomon reviewed the study for WebMD.

The findings are based on a study of more than 22,300 patients who were enrolled in another study that was trying to determine the effectiveness of clot-busting medications. None of the patients in that study had complications for 72 hours after being given the medication. Complications that can occur include a second heart attack, stroke, congestive heart failure, irregular heartbeats, and the need for emergency surgery to unclog arteries. Sixteen patients of the more than 22,300 had irregular heartbeats during the next 24-hour period. Three of them died.

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