Prevalence and Outcomes of Same-Day Discharge After Elective Percutaneous Coronary Intervention Among Older Patients

Abstract

Among selected low-risk Medicare patients undergoing elective PCI, same-day discharge is rarely implemented but is not associated with death or rehospitalization compared with overnight observation.

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.…”

“…However, what defines “carefully selected” elective PCI patients has been inconsistently applied, if defined at all 2, 3, 4, 5, 6, 7, 8, 9. Some studies have cautiously explored the feasibility of SDD beyond the low‐risk population,7, 10, 11, 12, 13, 14 but they were evaluated in selected patients or required protocols or checklists. To the best of our knowledge, there are no studies that evaluate SDD in a broader and higher‐risk elective PCI population using an explicit quantification of patient‐specific risks.…”

SCAI expert consensus statement: 2016 best practices in the cardiac catheterization laboratory: (Endorsed by the cardiological society of india, and sociedad Latino Americana de Cardiologia intervencionista; Affirmation of value by the Canadian Association of interventional cardiology–Association canadienne de cardiologie d'intervention)*

“…The length of stay for PCI is dependent on access site complications, patient comorbidities, and need for further procedures, therapy, or testing [55]. Selected patients after elective PCI can be considered for same-day discharge [56] if the appropriate monitoring time has been completed (usually 6-8 hr) and the discharge aligns with patient preference and physician approval.…”

Ambulatory transradial percutaneous coronary intervention: A safe, effective, and cost‐saving strategy

“…No specific risk factors for complications were identified in our population. Whereas several previous studies enrolled patients selected on relatively conservative criteria (8,(21)(22)(23), our population included a high percentage of patients with multivessel interventions, bifurcation lesions, and total coronary occlusions and was therefore representative of patients referred to catheterization laboratories in everyday practice. The risk of ischemic events was not increased in the patients who had complex lesions.…”