RESUMO
BACKGROUND: Decreasing the hospital length of stay (LOS) in ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI) is an issue which is related to reducing hospital costs. This study was aimed to determine the average number of hospital LOS among patients with STEMI treated by PPCI and predictors of longer LOS. METHODS: This cross-sectional study was performed on 561 patients with STEMI who referred to Heshmat Hospital, Rasht, north of Iran, within 2015-2018. As soon as STEMI was detected, patients were transferred to the catheterization laboratory (cath lab) in the shortest possible time and underwent PPCI. A questionnaire including characteristics of patients, procedures, and in-hospital adverse events was completed. Data were analyzed with SPSS software. RESULTS: The mean age of patients was 59.36 ± 11.90 years. 74.2% (n = 416) of subjects were men and 25.8% (n = 145) were women. The hospital LOS of 3 to 6 days had the highest prevalence up to 47%. The results of the multiple logistic regression showed that risk of hospital LOS > 6 days in unsuccessful percutaneous coronary intervention (PCI) was 33.2 versus 66.8 in successful PCI (P = 0.001). Moreover, the risk of hospital LOS > 6 days in subjects who had post-procedure complication, problems at admission, and primary comorbidities was 9.13 (7.22-11.53)-fold, 4.09 (2.86-5.85)-fold, and 1.75 (1.35-2.27)-fold more than those who had not, respectively. CONCLUSION: By identifying controllable predictive factors associated with prolonged hospitalization after PPCI, the length of hospitalization can be decreased; also, the patient remission can be enhanced and hospital costs reduced.
RESUMO
INTRODUCTION: Giant coronary artery aneurysm is an extremely rare form of coronary artery disease. The most common cause of coronary artery aneurysms is atherosclerosis. Although it is usually asymptomatic, it may have various clinical presentations, including angina, myocardial infarction or sudden death. CASE PRESENTATION: A 32-year-old woman presented with edema of the upper and lower limbs, palpitation, and chest pain, and was diagnosed with a giant right coronary artery aneurysm that had initially mimicked a mediastinal cyst. Although computed tomography (CT) suggested a mediastinal cyst, trans-thoracic echocardiography revealed an extra pericardial cyst. The definitive diagnosis of right coronary artery aneurysm was made based on CT angiography and coronary angiography findings. As treatment, aneurysmectomy was performed, and she was discharged on the sixth postoperative day with good general health condition. CONCLUSIONS: Coronary artery aneurysm should be a differential diagnosis in cases of mediastinal cyst and mass lesion.
