Left Ventricular Ejection Fraction along with Zwolle Risk Score for Risk Stratification to Enhance Safe and Early Discharge in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention: A Retrospective Observational Study.
| Autor: | Banga S; Cardiology, West Virginia University School of Medicine, Morgantown, USA., Gumm DC; Cardiology, University of Illinois College of Medicine at Peoria, Order of St. Francis Medical Centre, Peoria, USA., Kizhakekuttu TJ; Cardiology, University of Illinois College of Medicine at Peoria, Order of St. Francis Medical Centre, Peoria, USA., Emani VK; Internal Medicine, University of Illinois College of Medicine at Peoria, Order of St. Francis Medical Centre, Peoria, USA., Singh S; Pulmonary Medicine, Marshall University School of Medicine, Huntington, USA., Singh S; Internal Medicine, Southern Medical University, Guangzhou, CHN., Kaur H; Neurology, Univeristy of Missouri, Columbia, USA., Wang Y; Epidemiology and Public Health, University of Illinois College of Medicine at Peoria, Peoria, USA., Mungee S; Cardiology, University of Illinois College of Medicine, Order of St. Francis Medical Centre, Peoria, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2019 Jul 29; Vol. 11 (7), pp. e5272. Date of Electronic Publication: 2019 Jul 29. |
| DOI: | 10.7759/cureus.5272 |
| Abstrakt: | Introduction Zwolle risk score (ZRS) is a validated scoring system to determine the time of discharge in ST-segment elevation myocardial infarction (STEMI) patients. Left ventricular ejection fraction (LVEF) also provides prognostic information after ST-elevation myocardial infarction (STEMI). We studied that the addition of LVEF to ZRS variable can improve decision making in safe and early discharge in STEMI patients post-primary coronary intervention. Methods Overall, 249 STEMI patients were studied retrospectively. LVEF was considered as an independent variable. The patients having LVEF <50% were under Group A and LVEF ≥50% were under Group B. Groups were analyzed by model comparison for overall hospital length of stay (LOS) and Intensive care unit (ICU) LOS post-primary percutaneous coronary intervention (PCI). Results There were 123 patients in Group A and 126 patients in Group B. Comparison for primary outcomes showed significant difference with hospital length of stay (LOS) being 3.1 ± 2.3 days in Group A versus 2.1 ± 0.8 days in Group B ( p < 0.001). Similarly, ICU stay was also significantly higher in Group A with 36.5 ± 31.4 hours versus 24.0 ± 11.8 hours for Group B, which led to prolonged hospitalization for patients with LVEF <50%. Model 1 that considers ZRS individually is nested within Model 2 where ZRS and LVEF are considered together. The profile log-likelihood ratio test favors model 2 over model 1 ( p < 0.0001). Similarly for ICU LOS, R 2 = 0.12 (Model 1) < R 2 = 0.20 (Model 2). The F test favors model 2 over model 1 ( p < 0.0001). Conclusion We concluded that adding LVEF to Zwolle risk score gives a better model for risk stratification in STEMI patients to decide early and safe discharge post-primary PCI. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2019, Banga et al.) |
| Databáze: | MEDLINE |
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