{
  "abstract": "Introduction Primary percutaneous coronary intervention (PPCI) is the currently accepted treatment for patients presenting with ST elevation myocardial infarction (STEMI). Optimising post-PPCI length of stay is important for patient care, experience as well as efficient patient flow. Tools including the validated risk stratification Zwolle score and locally derived BARTS criteria support early discharge decisions. However, concordance between these two approaches remains unclear.We compared Zwolle score and BARTS criteria and established a consistent pathway for planning early discharges post PPCI at MFT.Methods We conducted a retrospective observational analysis of consecutive patients with STEMIs treated with PPCI at a single tertiary cardiac center. Zwolle score and BARTS early discharge criteria were retrospectively applied and agreement between the two approaches assessed using Cohen’s kappa. Outcomes included in-hospital complications, 30-day mortality and length of stay.Results A total of 327 patients were assessed, 5 were excluded due to incomplete data. Of the 322 patients, 70.5% met Zwolle criteria and 51.1% met BARTS criteria for early discharge (<48 hours) ( figure 1). Inter-rater reliability was fair between the scores (Cohen’s Kappa 0.38). The mean length of stay was 4.37 days in Zwolle eligible patients compared with 3.02 days in the BARTS criteria. Zwolle eligible patients experienced higher complications including fatal arrhythmias, acute heart failure and need for further inpatient re-intervention; in-hospital complications were less frequent in BARTS-eligible patients.Conclusions Zwolle score allows for early discharge of a wider group of patients, with the drawback of including individuals who have higher risk factors and tend to stay in the hospital longer. In contrast, the stricter BARTS criteria leaves out patients with early arrhythmias, unstable clinical conditions, or a greater number of complications. These two methods only moderately agree with each other in identifying low-risk patients. The current data lay the groundwork for further evaluation of well-structured and safe pathways for early patient discharge.Abstract 160 Figure 1Patient flow and comparative stratification of study group by BARTS criteria and Zwolle risk scores",
  "authors": [
    {
      "affiliations": [
        "Manchester University hospital Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "V Chinnasami"
    },
    {
      "affiliations": [
        "Manchester University hospital Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "R Siva"
    },
    {
      "affiliations": [
        "Manchester University hospital Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "K Srinivas"
    },
    {
      "affiliations": [
        "Manchester University hospital Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "S Thirunavukarasu"
    },
    {
      "affiliations": [
        "Manchester University hospital Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "VJ Karthikeyan"
    }
  ],
  "title": "160 A comparative study of discharge criteria for early discharge post ST elevation myocardial infarction: Zwolle score Vs BARTS criteria",
  "uid": "06895f1c-f87a-586d-b4fd-520efb88c8fb"
}