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  • Hospitalisation for more than 3 days after thrombolysis for uncomplicated myocardial infarction was not cost effective

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Economics
Hospitalisation for more than 3 days after thrombolysis for uncomplicated myocardial infarction was not cost effective
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http://dx.doi.org/10.1136/ebm.5.6.190

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    (2000) N Engl J Med 342, 749. Newby LK, Eisenstein EL, Califf RM. , et al. . Cost effectiveness of early discharge after uncomplicated acute myocardial infarction. . . Mar 16;. :. –55..
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 QUESTION: For patients who have had a low risk myocardial infarction (MI), is early discharge on day 3 instead of day 4 after thrombolysis safe and cost effective?

    Design

    Decision analytic model using data from a randomised controlled trial (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries [GUSTO-1]).

    Setting

    {1081 hospitals in 15 countries}*.

    Patients

    38 911 of 41 021 enrolled patients who presented with a confirmed MI 20 minutes to 6 hours after symptom onset and who had an uncomplicated course (absence of death, reinfarction, congestive heart failure, recurrent ischaemia, stroke, shock, emergency angiography or angioplasty, bypass surgery, intra-aortic balloon pumping, cardioversion, or defibrillation). Exclusion criteria were angiographic 3 vessel or left main coronary artery disease or elective bypass surgery >3 days after thrombolysis.

    Intervention

    Discharge at day 3 compared …

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