Outcomes of patients discharged the same day following percutaneous coronary intervention.
OBJECTIVE
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.
Patel
Mehul
M
Cardiac Catheterization Laboratory of the Zena and Michael A Weiner Cardiovascular Institute, Mount Sinai Hospital, New York, New York 10029-6754, USA.
Kim
Michael
M
Karajgikar
Rucha
R
Kodali
Visali
V
Kaplish
Dheeraj
D
Lee
Paul
P
Moreno
Pedro
P
Krishnan
Prakash
P
Sharma
Samin K
SK
Kini
Annapoorna S
AS
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D002985:Clinical Protocols; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009519:New York City; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors