Same-Day Discharge After Elective Percutaneous Coronary Intervention

Taxiarchi, Paraskevi; Kontopantelis, Evangelos; Martin, Glen P.; Kinnaird, Tim; Curzen, Nick; Banning, Adrian P.; Ludman, Peter; Belder, Mark de; Rashid, Muhammad; Sperrin, Matthew; Mamas, Mamas A.

doi:10.1016/j.jcin.2019.03.030

Cited by 32 publications

(17 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We undertook this study to assess the feasibility and safety of the procedure. Nonetheless, our work is consistent with our international counterparts who have showed that highly selected SDD-PCI patients had no difference in clinical outcomes at 30 days and had lower rates of clinical complications [2][3][4].…”

Section: Discussionsupporting

confidence: 91%

“…The increasing prevalence of coronary artery disease has led, in recent years, to growing number of percutaneous coronary interventions (PCI) worldwide [1]. However, PCI admissions represent a significant burden on the available resources and challenges healthcare systems to reduce costs of delivery without compromising access and safety [2][3][4]. Same-day discharge (SDD) PCI has the potential for reducing costs and achieving patient satisfaction while maintaining clinical effectiveness.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and Cost-Savings of Same-Day Discharge Trans-Radial Percutaneous Coronary Intervention in Trinidad and Tobago

Ramsingh¹,

Maharaj²,

Angelini³

et al. 2020

Cureus

View full text Add to dashboard Cite

Introduction: Same-day discharge percutaneous coronary interventions (SDD-PCI) may be quite impactful on healthcare burden for small island developing states (SIDS) such as Trinidad and Tobago. Methods: From June 2012 to November 2014, 11 patients underwent SDD trans-radial PCI and followed up at one-month and three months. Data was retrospectively reviewed from a prospectively entered unit-maintained cardiology database. Baseline patient characteristics, in-hospital expenditure, and complications were assessed. Descriptive statistical analysis was performed in Microsoft Excel. Results: The mean age at SDD-PCI was 50.90±9.96 and nine were male. Nine patients were of East Indian Caribbean ethnicity. Six were diabetic and five were hypertensive. Procedural success was 100% with no major early complication or three-months complications; patient satisfaction was achieved with a potential in-hospital savings up to $1480 USD per patient. Conclusion: This SDD approach for elective trans-radial PCI may be safe and cost-effective in properly selected patients and merits a review of relevant policy issues in Trinidad and Tobago.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Safety and Cost-Savings of Same-Day Discharge Trans-Radial Percutaneous Coronary Intervention in Trinidad and Tobago

Ramsingh¹,

Maharaj²,

Angelini³

et al. 2020

Cureus

View full text Add to dashboard Cite

show abstract

“…Prior study has revealed the safety of SDD; however, most of the studies are from healthcare facilities where SDD was not a common practice, and high-risk PCI cases (STEMI) were not included in the analysis. Most of the available evidence on SDD after PCI is for elective procedures,6 11–22 however, data on safety of SDD in the context of primary PCI are very limited. Due to the misbalanced ratio of procedures and resources in our part of the world, SDD after uncomplicated primary PCI remains a common practice but reported evidence regarding this is very limited.…”

Section: Discussionmentioning

confidence: 99%

One-year major adverse cardiovascular events among same-day discharged patients after primary percutaneous coronary intervention at a tertiary care cardiac centre in Karachi, Pakistan: a prospective observational study

et al. 2023

View full text Add to dashboard Cite

ObjectiveKnowledge regarding the short-term outcomes after same-day discharge (SDD) post primary percutaneous coronary intervention (PCI) is lacking. In this study, we evaluated 1-year major adverse cardiovascular events (MACE) among SDD patients after primary PCI.Design1-year follow-up analysis of a subset of patients from an existing prospective cohort study.SettingTertiary care cardiac hospital in Karachi, Pakistan.ParticipantsConsecutive patients, from August 2019 to July 2020, with ST segment elevation myocardial infarction who had undergone primary PCI with SDD (within 24 hours) after the procedure by the treating physician and with at least one successful follow-up up to 1 year.Outcome measureCumulative MACE during follow-up at the intervals of 1 week, 1 month, 6 months and 1 year.Results489 patients were included, with a gender distribution of 83.2% (407) male patients and a mean age of 54.58±10.85 years. Overall MACE rate during the mean follow-up duration of 326.98±76.71 days was 10.8% (53), out of which 26.4% (14/53) events occurred within 6 months of discharge and the remaining 73.6% (39/53) occurred between 6 months and 1 year. MACE was significantly higher among patients with a Zwolle Risk Score (ZRS) ≥4 at baseline, with an incidence rate of 21.9% (16/73) vs 8.9% (37/416; p=0.001) in patients with ZRS≤3 (relative risk 2.88 (95% CI 1.5 to 5.5)).ConclusionA significant burden of short-term MACE was identified among SDD patients after primary PCI; most of these events occurred after 6 months of SDD, mainly among patients with ZRS≥4. A systematic risk assessment based on risk stratification modalities such ZRS could be a viable option for SDD patients with primary PCI.

show abstract

“…In the United States, adoption of SDD is only 14%, compared to 30% in Canada 14 and 57% in the United Kingdom. 13,15 The 2009 consensus document from the Society for Cardiovascular Angiography and Interventions (SCAI) released criteria for SDD, 16 which we followed in the development of our SDD program. Over time, several randomized and observational studies demonstrated the safety of SDD in high-risk patient subgroups, 15,[17][18][19][20][21][22][23][24][25] which led to a change in the recommendations and definition of high-risk PCI.…”

Section: Introductionmentioning

confidence: 99%

“…13,15 The 2009 consensus document from the Society for Cardiovascular Angiography and Interventions (SCAI) released criteria for SDD, 16 which we followed in the development of our SDD program. Over time, several randomized and observational studies demonstrated the safety of SDD in high-risk patient subgroups, 15,[17][18][19][20][21][22][23][24][25] which led to a change in the recommendations and definition of high-risk PCI. 26 New guidelines have also been developed to determine which patients are considered safe for SDD.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of same‐day discharge following percutaneous coronary intervention in a rural population

Ginete

Groth

Rudeck

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

BackgroundSame‐day discharge (SDD) following percutaneous coronary intervention (PCI) is safe, yet the nationwide rate of SDD remains low. The impact that residing in a rural area has on the safety of SDD is unknown.ObjectiveTo investigate the safety of SDD compared to next‐day discharge (NDD) among PCI patients living in a largely rural area.MethodsThere were 3502 outpatient elective PCIs at a tertiary care center between January 1, 2011 and December 31, 2017. Data from the National Cardiovascular Data Registry CathPCI Registry® and the electronic medical records were obtained for patient demographics, procedural characteristics, and procedural outcomes. Data from the initial PCI in each 365‐day period were included in the analysis for each patient. Rural–Urban Commuting Area codes 4–10 were used to define rural status.ResultsA total of 2099 (59.9%) PCIs met the inclusion criteria (63% rural). The overall rate of SDD increased over time (4.7% in 2011 to 39.6% in 2017) as radial access increased (14.2% in 2011 to 59.9% in 2017). In this population, a total of 329 PCIs had SDD (15.7%; median (interquartile range) age 66.0 (14.0) years, 20.1% female, 52.3% rural status). Compared to NDD, SDD patients had less hyperlipidemia, atrial fibrillation, congestive heart failure, history of coronary artery bypass graft, and more radial access. SDD was noninferior to NDD for 30‐day readmission but had a decreased 1‐year (adjusted odds ratio [aOR]: 0.20, 95% confidence interval [CI]: 0.05–0.81, p = 0.024) and 5‐year (aOR: 0.43, 95% CI: 0.28–0.66, p < 0.001) all‐cause mortality compared to NDD. Rural status did not predict outcomes.ConclusionsSDD in patients in rural areas does not have a significantly higher rate of 30‐day readmission. SDD patients had lower odds of 1‐ and 5‐year mortality when compared to NDD. Future studies prospectively evaluating the safety of SDD in this population are warranted.

show abstract

Same-Day Discharge After Elective Percutaneous Coronary Intervention

Cited by 32 publications

References 37 publications

Safety and Cost-Savings of Same-Day Discharge Trans-Radial Percutaneous Coronary Intervention in Trinidad and Tobago

Safety and Cost-Savings of Same-Day Discharge Trans-Radial Percutaneous Coronary Intervention in Trinidad and Tobago

One-year major adverse cardiovascular events among same-day discharged patients after primary percutaneous coronary intervention at a tertiary care cardiac centre in Karachi, Pakistan: a prospective observational study

Outcomes of same‐day discharge following percutaneous coronary intervention in a rural population

Contact Info

Product

Resources

About