title: Assessment of clinical outcomes related to early discharge after elective percutaneous coronary intervention: COED PCI.
abstract: OBJECTIVE
  To assess clinical outcomes of same-day discharge (SDD) patients after elective percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  An overnight stay after PCI has been the standard approach in the majority of institutions. Data supporting SDD while maintaining patient safety, based on contemporary United States practice, have not been well established.
  
  
  METHODS
  Using institutional pre-, peri-, and post-procedural guidelines, short-term clinical outcomes of 200 consecutive patients discharged on the same day after elective PCI were prospectively studied. Major adverse cardiac events (MACE), access site and vascular complications, readmissions, and emergency room (ER) visits were assessed within 24 hrs and at 7-day post-SDD. MACE included cerebral vascular accidents, death, myocardial infarction, target vessel revascularization, pulmonary embolism, and emergent coronary artery bypass grafting.
  
  
  RESULTS
  The mean age of the population was 63.2 years; 75% were males. Of 200 patients, 75.5% were accessed femorally and 24.5% had radial access. Intra-procedural anticoagulation included bivalirudin alone (47%), bivalirudin with glycoprotein (GP) IIb/IIIa inhibitors (3.5%), heparin alone (37%), and heparin with GP IIb/IIIa inhibitors (12.5%). No major bleeding or MACE was reported within 24 hrs or at 7 days. Within 7 days, 8 (4%) patients experienced minor bleeding, 4 (2%) were readmitted, and 3 (1.5%) had ER visits only. Pseudoaneurysm occurred in 1 (0.5%) patient.
  
  
  CONCLUSIONS
  Our institution-specific guidelines identify low-risk PCI patients who can be safely considered candidates for SDD with virtually no short-term adverse consequences.
authors: Department of Research, Grand Rapids Medical Education Partners, Grand Rapids, Michigan, USA. Purush.Muthusamy@spectrumhealth.org
authors: Purushothaman
authors: P
authors: Muthusamy
authors: Denise K
authors: DK
authors: Busman
authors: Alan T
authors: AT
authors: Davis
authors: David H
authors: DH
authors: Wohns
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000639:trends; D061214:Patient Safety / Q000706:statistics & numerical data*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States