A single center experience with same‐day transradial‐PCI patients: A contrast with published guidelines

Abstract

Using transradial approaches and structured early follow up by advance practice nurses, same-day discharge can be accomplished successfully in a broad range of patients outside of those suggested by the SCAI/ACC 2009 Consensus Document. Confirmation of these results could result in shorter hospitalizations for US patients and align advances in catheterization technology to optimize heath care delivery.

Novel Patient‐Centered Approach to Facilitate Same‐Day Discharge in Patients Undergoing Elective Percutaneous Coronary Intervention

“…There is an emerging body of literature7, 12, 14, 28 suggesting that SDD may be performed in more complex and elderly patients undergoing PCI, in whom complex characteristics alone are not sufficient indicators for necessitating overnight admission. Unfortunately, the existing SDD “criteria,”17 which are applicable to a lower‐risk population, are potentially too conservative to be applied in an increasingly complex elective PCI population treated in contemporary practice.…”

An Audit of Outcomes After Same‐Day Discharge Post‐PCI in Acute Coronary Syndrome and Elective Patients

“…Whether this guidance accurately reflects what can safely be performed in real‐world transradial PCI in 2013 is not clear, where the changing profile of modern PCI has seen an increasing workload of older, unstable and higher‐risk patients. Studies have suggested that same‐day discharge is safe in a broader range of patients with increased case complexity . No guidelines exist in the United Kingdom (UK), and although practice varies, the default in many centers is for some elective patients to stay overnight post‐PCI and, depending on their course, for convalescent ACS patients to stay at least 1 night after revascularization.…”

Implementation Strategies for Same Day Discharge Post Percutaneous Coronary Intervention: An Integrative Review

“…Of the 19 articles included in this review, five were multisite and the remaining 14 studies were single-center studies. About one-third (n = 7) of the studies were conducted in the United States (Gilchrist, Rhodes, & Zimmerman, 2012;Glaser et al, 2009;Kim et al, 2013;Knopf et al, 1999;Muthusamy, Busman, Davis, & Wohns, 2013;Rao et al, 2011;Wilentz et al, 1999). The remaining 12 studies were completed in the United Kingdom (n = 4; Brewster et al, 2013;Dalby et al, 2003;Hodkinson et al, 2013;Kumar et al, 2004), Canada (Rao et al, 2011) Cohort study N = 107,018 100%…”

“…Only one study reported addressing cardiac rehabilitation (Muthusamy et al, 2013). Cardiac education was only provided in four studies (Gilchrist et al, 2012;Knopf et al, 1999;Muthusamy et al, 2013;Wilentz et al, 1999).…”

“…Same Day Discharge Guideline or Protocol. Six papers described using a procedure protocol, or a guideline as a way of implementing SDD (Antonsen et al, 2013;Dalby et al, 2003;Gilchrist et al, 2012;Hodkinson et al, 2013;Muthusamy et al, 2013;Rao et al, 2011). For example, Antonsen et al (2013) implemented SDD using a guideline that specified each criterion patients needed to fulfill to be deemed eligible for SDD.…”