EARLY MOBILISATION AND DISCHARGE OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTTON

Abstract The operation of a mobile coronarycare unit in addition to a hospital coronary-care unit (C.C.U.) increases the demand for monitoring facilities and convalescent beds. Early mobilisation and early discharge of patients not at risk is therefore important. The results of such a policy in patients with acute myocardial infarction admitted to a C.C.U. are reported. 18% of patients were discharged by the seventh day, and 62% spent ten days or less in hospital. The subsequent mortality and readmission-rate suggest that early discharge was not harmful. Factors which predicted the risk of dying between the end of the first week and three months were assessed. A coronary prognostic index of 6 or more, significant ventricular arrhythmias in the first forty-eight hours, sinus tachycardia, persistent ST-segment elevation, and recurrent ischaemic pain or recurrent arrhythmia were all associated with increased mortality. The last three factors were used to define a group of patients (57%) of whom none had died at three-month follow-up.