CORONARY-CARE UNIT REQUIREMENTS OF PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION TREATED WITH OR WITHOUT THROMBOLYTIC THERAPY - A PILOT-STUDY

Objective: To determine if patients with acute myocardial infarction w ho receive thrombolytic therapy require more nursing care hours and a longer length of stay in the coronary care unit than those patients wi th acute myocardial infarction who do not receive thrombolytic therapy . Design: Retrospective cohort study using the coronary care unit data base and patient classification records. Setting: Northeastern univer sity-affiliated, community-based, cardiovascular tertiary care center. Patients: All patients admitted to the coronary care unit with a diag nosis of acute myocardial infarction were screened. Of these, 20 patie nts who also had a patient classification form completed were included in the study. Ten of these patients had received thrombolytic therapy and 10 had not. The patients were grouped according to treatment with a thrombolytic agent or conventional treatment. There was no signific ant difference in age between the groups (64 +/- 19 years and 67 +/- 1 5 years). Outcome Measures: Nursing care hours per patient per day and length of stay per patient in the coronary care unit. Results: On day s 1 and 2 of hospitalization, there were no significant differences in total nursing care hours provided per patient per day. On days 3 and 4, those patients who received thrombolytic therapy received fewer nur sing care hours compared with those who did not (11.1 and 9.2 vs 13.8 and 12.7 hours per patient day, respectively; p less-than-or-equal-to 0.05). Patients who were treated with thrombolytic therapy also had a significantly shorter coronary care unit stay (3.1 vs 4.0 days; p less -than-or-equal-to 0.05). Conclusion: In this retrospective, observatio nal pilot study, patients who received thrombolytic therapy for treatm ent of acute myocardial infarction had a significantly shorter coronar y care unit stay and required significantly less nursing care on days 3 and 4.