Decreased Length of Stay in the Intensive Cardiac Care Unit with Preserved Clinical Outcome Over the Last Decade

Background: Significant advances in the medical and invasive treatment of acute myocardial infarction (MI) and new interventional procedures have occurred in the last decade.

Objective: To evaluate whether these changes influenced the hospitalization length of stay in the intensive cardiac care unit (ICCU).

Methods: We retrospectively evaluated the clinical and demographic characteristics of all the patients hospitalized at our tertiary center ICCU during the last 10 years. The data was obtained from the hospital medical information system. The patients were divided into two periods; an earlier period (2005-2010) and a recent period (2010-2015).

Results: We enrolled 5,110 patients, 2,601 between 2005-2010 and 2,509 between 2010-2015. ICCU length of stay decreased by almost one day between the earlier and recent period (Median 3.5 vs. 2.4 days, respectively, P<0.001). There was no change in the total hospitalization length between the two groups (5.2 vs. 5.1 days, P=0.22). This decrease in the ICCU length of stay didn’t change the prognosis of these patients, as the total mortality and the recurrent hospitalization rate were similar in these two groups (P=0.72). This decrease occurred despite an increase in the age of the patients (median age 63 vs. 65 years, P=0.004) and patients had more comorbidities - hyperlipidemia (52% vs. 58%, P<0.001) and hypertension (55% vs. 61%, P<0.001). The decrease in ICCU length of stay was evident in all types of admissions; post elective procedures: 4.6 to 3.1 days (P<0.001), arrhythmia’s (not related to ACS): 4.2 to 2.9 days (P<0.001), ST elevation MI: 3.7 to 2.3 days (P<0.001) and non-ST elevation MI: 3.6 to 2.1 days (P<0.001).

Conclusion: Length of stay in the ICCU dropped significantly over the last decade, even though the patients were older and had more comorbidities. The decrease didn’t change the total mortality and re-hospitalization rate.