Reconnaissance des diplômes étrangers. L’exercice en France de la médecine et des professions paramédicales est réglementé et les diplômes étrangers ne. Laurent Lebard. Chambéry Area, France Chef d’entreprise chez YIELDIN Information Technology and Services Education Ecole de Management de Lyon / EM. Luxembourg Avocat à la Cour at Etude Weber Stein Thiel & Associés Law Practice Education Université Paris Sud (Paris XI) / University Paris XI —

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This study confirms that a strategy of early hospital discharge within two days of admission after a STEMI does not raise the risk of mortality in selected patients.

It is an honor to have you present for the day of my thesis defense. Safety and feasibility of hospital discharge 2 days following primary percutaneous intervention for ST-segment elevation myocardial infarction. Moreover it biostatlstique allow for a rapid cardiac rehabilitation associated with an educational program on cardiac follow-up. Hence, the number of patients potentially concerned by a strategy of early discharge is very large and, in a similar manner, an increase in the economic savings biostatistiqye perspective could be envisioned since our study showed that there was no long-term mortality rise.

Timing, setting and incidence of cardiovascular complications in patients with acute myocardial infarction submitted to primary percutaneous coronary intervention. Catheterisme cardiaque – Cliniques universitaires Saint-Luc. Nevertheless, this study was focused upon mortality rates as well as measuring the finite endpoint of mortality with a longterm follow-up of one biostatistiqque.

Sortie precoce post-infarctus du myocarde

Data regarding re-hospitalization after discharge were lacking. Relation of length of hospital stay in acute myocardial infarction to postdischarge mortality.

Indeed, these criteria determined which patients were at low risk of complications and who would benefit from an early hospital discharge 13— One could speculate that higher blood levels of creatinine in the late discharge group led to lower prescription rates of ACE inhibitors.

One could speculate that the increasing use of Thienopyridines would lead to a decreased use of AntiGp2b3a. The feasibility and safety of early discharge for low risk patients with acute myocardial infarction after successful direct percutaneous coronary intervention. Included in the potential reasons for decreasing the LOS, there are constant economic and societal pressures 7, 8 aimed at reducing the average LOS to optimize expenditures without, however, taking into account the cost efficiency of this strategy and the well-being of the patients.


At one-year follow-up, 27 patients 1.

Therefore, their results are less able to be extrapolated and to be used in the everyday practice pcem11 a CICU. Feasibility and safety of an early discharge strategy after low-risk acute myocardial infarction treated with primary percutaneous coronary intervention: Moreover, during this same period, the short-term prognostic of the STEMI’s has improved 3—6 due to several elements such as a better understanding of the delay in the onset of complications, improvements in strategies and equipments for reperfusion and biostaristique in drug therapies.

Je ferai tout pour soulager les souffrances. This reperfusion strategy is recommended because it leads to better outcomes The variables that were found to be significant in the univariate analyses were candidates for the multivariate analyses. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. These include the prevention of complications acquired at the hospital i.

Merci de m’avoir soutenu dans l’aboutissement de ce projet.

In comparison to the late discharge group, the earlier discharged patients were younger in age 57[] vs.

All patients with missing data were not analyzed. One could speculate that an early discharge from the hospital would reduce the information given to the patient concerning the state of his health after a STEMI and would complicate the patient’s therapeutic education and the correct introduction of the treatments recommended for post-STEMI secondary prevention treatments. Prognostic assessment of patients with acute myocardial infarction treated with primary angioplasty: Also inAzzalini et al.

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Heart Br Card Soc. Their exclusion criteria were numerous. Trends and predictors of length of stay after primary percutaneous coronary intervention: Statistical analysis Patients were classified as described above according to where they went after their stay at the CICU: In the univariate analyses, we selected and tested the criteria which seemed to be relevant according to the literature; i.

A direct comparison of intravenous enoxaparin with unfractionated heparin in primary percutaneous coronary intervention from the ATOLL trial. This care network covers a large territory both rural and urban and spans five administrative regions with a population of more than three million inhabitants. Can we improve length of hospitalization in ST elevation myocardial infarction patients treated with primary percutaneous coronary intervention?


Limitations and strengths A limitation inherent biostatstique our study was its observational, retrospective and non- randomized design that may have induced potential bias between the groups.

This allowed us to assess se safety and feasibility of early discharge as the primary goal. Nevertheless, it is necessary to adopt an individual approach in the administered medical care. Determinants of early discharge The early discharge patients possessed clinical particularities: Safety and feasibility of early hospital discharge in ST-segment elevation myocardial infarction–a prospective and randomized trial in low-risk primary percutaneous coronary intervention patients the Safe-Depart Trial.

Implications for timing of discharge and applications to medical decision-making. Next day discharge after successful primary angioplasty for acute ST elevation myocardial infarction. According to the ESC 9coronary artery disease is the single most frequent cause of death accounting for more than 7 million people every year or J Am Coll Cardiol.

Survival outcomes At one-year follow-up, 27 patients 1. Two of these centers are in public University Hospitals, four are in public General Hospitals and four are in private clinics. Primary Angioplasty in Myocardial Infarction. Declining length of stay for patients hospitalized with AMI: Early discharge after primary percutaneous coronary intervention for ST-elevation myocardial infarction. To assess the predictive value of LOS, survival was estimated by Kaplan—Meier survival curves log-rank statistic according to early or late discharge characteristics.

From a socio-economic point of view, the objective of reducing the average LOS to optimize hospital expenditures receives constant economic and social pressures. An additional limitation to our study was the missing data of the presence or absence of multi-vessel coronary disease.