P5488Temporal trends and prognostic impact of hospital length of three or less days in uncomplicated myocardial infarction after primary percutaneous coronary intervention in Spain

Abstract Introduction and objectives There is scarce data on the safety of hospital stay length in uncomplicated ST- elevation myocardial infarction (STEMI). We studied the trends of the hospital stay and the safety of short (≤3 days) vs. long hospital stay, in Spain. Methods Using data from the Minimum Basic Data set of Spanish taxpayer-funded health system. We identified patients with uncomplicated STEMI undergoing coronary angioplasty and who were discharged alive. The mean length of stay was calculated by multilevel Poisson regression with mixed-effects, including patients from 2003–15. The effect of short stay on cardiac diseases readmissions at 30 days and 1 year was evaluated by multilevel logistic regression, including patients from 2003–14. Thirty-day and 1-year cardiac diseases risk-standardized readmissions and mortality rates (RSRRs and RSMRs), respectively, were also compared. Results The adjusted mean length of stay was significantly reduced (incidence rate ratio <1; p<0.001) for each year since 2003. The percentage of short stay increased from 14.3% in 2003 to 19.5% in 2015 (p<0.001). In none of the specified models short stay was statistically significant (p>0.05). The RSRRs at 30 days and 1 year as well as RSMRs at 30 days, did not differ significantly between groups. 1-year RSMRs was significantly higher in the short stay group, although probably without clinical significance (0.103% vs. 0.109%, p<0.001). See Table. Diff mean of RSRRs and RSMRs at 30 days & 1 year Stay length N Mean Standard deviation p-value RSRRs at 30-day ≤3 days 6,486 2.541 0.74 0.20 >3 days 31,651 2.554 0.72 RSRRs at 1 year ≤3 days 6,486 5.306 1.22 0.42 >3 days 31,651 5.292 1.14 RSMRs at 30-day ≤3 days 6,486 0.109 0.04 <0.001 >3 days 31,651 0.103 0.03 RSMRs at 1 year ≤3 days 6,486 0.429 0.13 0.25 >3 days 31,651 0.427 0.13 RSRRs = risk-standardized readmission rates; RSMRs = risk-standardized readmission mortality rates. Conclusions In Spain, short hospital stay increased significantly from 2003 to 2015 and seems a safety option in uncomplicated STEMI patients.