1. Outcomes of Patients Discharged the Same Day Following Percutaneous Coronary Intervention
- Author
-
Michael C. Kim, Samin K. Sharma, Paul Lee, Dheeraj Kaplish, Visali Kodali, Prakash Krishnan, Pedro R. Moreno, Mehul B. Patel, Rucha Karajgikar, and Annapoorna Kini
- Subjects
Adult ,safety ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Population ,same-day discharge ,selection ,Coronary Artery Disease ,registry ,Coronary Angiography ,Clinical Protocols ,Angioplasty ,Humans ,Medicine ,cost-saving ,Registries ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,education ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,percutaneous coronary intervention ,Percutaneous coronary intervention ,Retrospective cohort study ,Thrombolysis ,Length of Stay ,Middle Aged ,medicine.disease ,DES ,Patient Discharge ,Surgery ,Outcome and Process Assessment, Health Care ,Treatment Outcome ,Conventional PCI ,New York City ,business ,Complication ,Cardiology and Cardiovascular Medicine ,Platelet Aggregation Inhibitors - Abstract
Objectives This study evaluated the outcomes of patients discharged the day of percutaneous coronary intervention (PCI) by analyzing the data from a single-center, large, multioperator registry of interventions. Background Although same-day discharge is likely safe after interventions on low-risk stable patients, there is limited data to guide selection of a broader population of patients. Due to numerous patient variables and physician preferences, standardization of the length of stay after PCI has been a challenge. Most of the reported studies on same-day discharge have strict inclusion criteria and hence do not truly reflect a real-world population. Methods We analyzed the outcomes of consecutive same-day discharge in 2,400 of 16,585 patients who underwent elective PCI without any procedural or hospital complication. Composite end point included 30-day major adverse cardiac cerebral events and bleeding/vascular complications. Results The mean age of the study population was 57.0 ± 23.7 years with 12% aged over 65 years. Twenty-eight percent received glycoprotein IIb/IIIa inhibitor with closure devices in 90.5%. Clinical and angiographic success was noted in 97% of all PCIs. The average length-of-stay following PCI was 8.2 ± 2.5 h. The composite end point was reached in 23 patients (0.96%). Major adverse cardiac cerebral events occurred in 8 patients (0.33%) and vascular/bleeding complications in the form of Thrombolysis In Myocardial Infarction minor bleeding in 14 patients (0.58%) and pseudoaneurysm in 1 patient (0.04%). Conclusions When appropriately selected, with strict adherence to the set protocol, same-day discharge after uncomplicated elective PCI is safe despite using femoral access in a wide spectrum of patients.
- Full Text
- View/download PDF