Implementation of an Early Discharge Protocol in Patients with ST-Segment Elevation Myocardial Infarction

Clinical guidelines do not clearly define hospitalization time after primary angioplasty in ST-segment elevation myocardial infarction (STEMI). The hospitalization time should be tailored according to risk stratification. Aim: Evaluation of a local early discharge protocol to identify low-risk patients after primary angioplasty. Methods: A local protocol was applied to all patients admitted to Las Higueras Hospital after primary angioplasty in the context of STEMI from the Health Service of Talcahuano (Those belonging to other Health Services were excluded). Those who met the established criteria were discharged < 48 hours. Clinical variables, comorbidities, angiographic characteristics, and the procedure, as well as intraoperative complications, mortality, and hospital readmission up to 6 months, were analyzed. Results: A total of 51 patients were identified, with a mean age of 59.5 years and 25% female. The mean ischemia time was 5.5 hours with a risk profile that showed a mean GRACE score of 106 and a Zwolle risk score of 1.7. The mean length of stay was 1.7 days (40.8 h). There was only 1 readmission and no mortality events were registered up to 6 months of follow-up. Conclusion: The application of a protocol for early discharge after primary angioplasty allowed for shorter hospital stays without compromising patient safety in the medium term.