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Evidence summaries

Bed Rest for Myocardial Infarction

Short duration of bed rest (2 to 12 days, median 6 days) may be associated with similar outcomes as longer bed rest (13 days or more, median 13) after myocardial infarction. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 15 studies with 1487 subjects assigned to a short period of bed rest (median 6 days) and 1471 patients assigned to longer bed rest (median 13 days). Generally the studies were outdated and appeared to be of moderate to poor methodological reporting quality. There was no evidence that shorter bed rest was more harmful than longer bed rest in terms of all cause mortality (RR=0.85 (95%CI 0.68 to 1.07), cardiac mortality (RR=0.81 (95%CI 0.54 to 1.19), or reinfarction (RR=1.07 (95%CI 0.79 to 1.44)).

Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment and blinding) and by indirectness (the studies were outdated). The authors state that current practice has moved to markedly shorter durations of bed rest (no more than 12-24 hours). However, such advice is not based on any randomised evidence and the optimal duration of bed rest will remain unknown without further trials.

    References

    • Herkner H, Arrich J, Havel C, Müllner M. Bed rest for acute uncomplicated myocardial infarction. Cochrane Database Syst Rev 2007 Apr 18;(2):CD003836 [Review content assessed as up-to-date: 11 October 2009]. [PubMed]

Primary/Secondary Keywords