Same-day transfer of patients with unstable angina and non-ST segment elevation myocardial infarction back to their referring hospital after angioplasty

Hoa, Doan; Dalery, Karl; Gervais, André; Harvey, Richard A.; Lepage, Serge; Maltais, Andrée; Nguyen, Michel

doi:10.1016/s0828-282x(06)70926-6

Cited by 10 publications

(19 citation statements)

References 8 publications

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“…This may be related to the high number of patients with normal coronary arteries included, the preplanned selection for overnight stay, as well as the transfer facilities and distance to the referring hospital. Compared to the study of Hoa Do et al, 7 more patients in our study did not undergo PCI. The high sensitivity of troponin assays have increased the number of patients with suspected ACS, resulting in more patients with a negative angiography.…”

Section: Discussioncontrasting

confidence: 68%

Safe and feasible immediate retransfer of patients to the referring hospital after acute coronary angiography and percutaneous coronary angioplasty for patients with acute coronary syndrome

Andersen

Kløw

Johansen

2013

European Heart Journal: Acute Cardiovascular Care

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Background: The challenge with fast track (FT) is to avoid compromising medical safety. We aimed to investigate whether patients with acute coronary syndrome could be safely retransferred to the referral hospital on the same day after coronary angiography and/or percutaneous coronary angioplasty (PCI). Methods and results: A total of 399 consecutive patients were prospectively randomized: 206 to ordinary care (OC) and 193 to the FT group. Of these, 30% of patients were admitted for unstable angina pectoris and 70% for non-STsegment elevation myocardial infarction. The FT patients were evaluated for possible same-day return after angiography and/or PCI. Crossover, acute, and 30-day major events were recorded. The radial approach was used in 91 and 87% in the OC and FT group, respectively. Of the FT patients, 95% were returned on the same day and nine crossover patients (4.7%) the next day or later. Major events occurred in nine patients (2.2%); five in the OC and four in the FT group. There were a total of five events within 24 hours. No events were observed during transportation and there were no early retransfers. Conclusions: Immediate written reports and good communication with the referring hospital enabled thoroughly selected patients to be safely returned on the same day as angiography and/or PCI.

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Section: Discussioncontrasting

confidence: 68%

Safe and feasible immediate retransfer of patients to the referring hospital after acute coronary angiography and percutaneous coronary angioplasty for patients with acute coronary syndrome

Andersen

Kløw

Johansen

2013

European Heart Journal: Acute Cardiovascular Care

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“…One of the more concerning results of this report is the higher apparent mortality in back‐transferred patients, a finding that holds even when compared with PS‐matched controls. This contradicts prior data on back‐transfer in cardiology and neonatology patients …”

Section: Discussioncontrasting

confidence: 95%

“…In Europe, backtransfer is used for patients undergoing routine coronary angiography and percutaneous coronary intervention (PCI). [10][11][12][13] This practice was found to be safe and feasible with regard to re-admission, mortality, and other complications. 13 In the United States, back-transfer has been shown to be safe for stable neonates after a hospitalization at a tertiary care neonatal intensive care unit.…”

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confidence: 91%

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Safety of Back‐Transfer to Local Hospitals During an Acute Care Hospitalization

Nelson

Harland

Shane

et al. 2017

The Journal of Rural Health

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“…Several observational studies, and some randomized controlled trials (RCTs), have aimed to prove that same-day or early discharge after PCI is both feasible and safe. The patient populations in these studies include those with elective PCI, unstable angina pectoris (UAP), non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI) patients 6,7…”

Section: Introductionmentioning

confidence: 99%

Early discharge compared with ordinary discharge after percutaneous coronary intervention – a systematic review and meta-analysis of safety and cost

Abdelnoor

Andersen

Arnesen

et al. 2017

VHRM

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AimWe aimed to summarize the pooled effect of early discharge compared with ordinary discharge after percutaneous coronary intervention (PCI) on the composite endpoint of re-infarction, revascularization, stroke, death, and incidence of rehospitalization. We also aimed to compare costs for the two strategies.MethodsThe study was a systematic review and a meta-analysis of 12 randomized controlled trials including 2962 patients, followed by trial sequential analysis. An estimation of cost was considered. Follow-up time was 30 days.ResultsFor early discharge, pooled effect for the composite endpoint was relative risk of efficacy (RRe)=0.65, 95% confidence interval (CI) (0.52–0.81). Rehospitalization had a pooled effect of RRe=1.10, 95% CI (0.88–1.38). Early discharge had an increasing risk of rehospitalization with increasing frequency of hypertension for all populations, except those with stable angina, where a decreasing risk was noted. Advancing age gave increased risk of revascularization. Early discharge had a cost reduction of 655 Euros per patient compared with ordinary discharge.ConclusionThe pooled effect supports the safe use of early discharge after PCI in the treatment of a heterogeneous population of patients with coronary artery disease. There was an increased risk of rehospitalization for all subpopulations, except patients with stable angina. Clinical trials with homogeneous populations of acute coronary syndrome are needed to be conclusive on this issue.

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Same-day transfer of patients with unstable angina and non-ST segment elevation myocardial infarction back to their referring hospital after angioplasty

Cited by 10 publications

References 8 publications

Safe and feasible immediate retransfer of patients to the referring hospital after acute coronary angiography and percutaneous coronary angioplasty for patients with acute coronary syndrome

Safe and feasible immediate retransfer of patients to the referring hospital after acute coronary angiography and percutaneous coronary angioplasty for patients with acute coronary syndrome

Safety of Back‐Transfer to Local Hospitals During an Acute Care Hospitalization

Early discharge compared with ordinary discharge after percutaneous coronary intervention – a systematic review and meta-analysis of safety and cost

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Same-day transfer of patients with unstable angina and non-ST segment elevation myocardial infarction back to their referring hospital after angioplasty

Cited by 10 publications

References 8 publications

Safe and feasible immediate retransfer of patients to the referring hospital after acute coronary angiography and percutaneous coronary angioplasty for patients with acute coronary syndrome

Safe and feasible immediate retransfer of patients to the referring hospital after acute coronary angiography and percutaneous coronary angioplasty for patients with acute coronary syndrome

Safety of Back‐Transfer to Local Hospitals During an Acute Care Hospitalization

Early discharge compared with ordinary discharge after percutaneous coronary intervention &ndash; a systematic review and meta-analysis of safety and cost

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Early discharge compared with ordinary discharge after percutaneous coronary intervention – a systematic review and meta-analysis of safety and cost