title: Assessing patient-reported outcomes and preferences for same-day discharge after percutaneous coronary intervention: results from a pilot randomized, controlled trial.
abstract: BACKGROUND
  Same-day discharge after percutaneous coronary intervention (PCI) may be safe for some patients. Few data are available on patient-reported outcomes and preferences for same-day discharge after PCI.
  
  
  RESULTS
  Between March 2008 and March 2010, a total of 298 patients undergoing elective PCI via femoral access at 2 medical centers (Mount Sinai Hospital, New York, NY, and Baylor Medical Center, Dallas, TX) were randomized to same-day (n=150) or next-day (n=148) discharge. The primary outcome was high patient coping during the 7 days after discharge defined as scores <20 on the validated postdischarge coping difficulty scale. Safety outcomes, clopidogrel adherence, and patient preferences were secondary outcomes. Before discharge, patients randomized to same-day and next-day discharge were similar with respect to sociodemographic and clinical characteristics. High-coping ability, assessed 7 days after PCI, was present for 79% of patients randomized to same-day discharge and for 77% of patients randomized to next-day discharge. The difference in high coping ability, 2 (95% confidence interval, -7 to 11), did not cross the noninferiority threshold of -12% (P<0.001 that same-day discharge is not noninferior to next-day discharge). At 30 days after PCI, clopidogrel adherence, physician and emergency room visits, and hospitalization were similar in the 2 randomization groups. In addition, 80% and 68% of those randomized to same-day and next-day discharge, respectively, stated they would prefer same-day discharge if they were to have another PCI procedure.
  
  
  CONCLUSIONS
  Same-day discharge after PCI was associated with patient-reported and clinical outcomes similar to those of next-day discharge and was preferred by most patients.
authors.affiliation: Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Kim
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Samin
authors.initials: S
authors.lastname: Sharma
authors.forename: James W
authors.initials: JW
authors.lastname: Choi
authors.forename: Robert C
authors.initials: RC
authors.lastname: Stoler
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.forename: Devin M
authors.initials: DM
authors.lastname: Mann
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farkouh
mesh_terms: D000046:Academic Medical Centers; D000223:Adaptation, Psychological; D016009:Chi-Square Distribution; D000077144:Clopidogrel; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009519:New York City; D009819:Office Visits; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D057240:Patient Preference; D010359:Patient Readmission; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013781:Texas; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine