Unplanned admissions after outpatient cardiac catheterization

Abstract

Summary:Increasing numbers of patients are undergoing diagnostic catheterization as outpatients; however, a small proportion of patients requires hospital admission following the procedure. Unplanned admissions after consecutive outpatient tively reviewed to determine the incidence of and reasons for admission. Among 847 patients undergoing outpatient cardiac catheterization, 130 patients (1 5%) required hospital admission after the procedure. Admitted patients were divided into luminal coronary angioplasty (FICA) (Croup 1; 33%). patients with severe cardiac disease requiring urgent intervention (Group 2; 48%), patients suffering complications or hemodynamic instability (Group 3; 15%), and patients whose procedures were completed too late to allow same-day discharge (Group 4; 4%). Patients over 65 were more likely to require admission and women were more likely to be admitted with complications or hemdynamic instability. Findings are compared with results of other outpatient series, and implications reganling ap propriate setting for outpatient cathetehtion are discussed.cardiac catheterizations performeed during 1 Y~XX W= P~O S~~C -four groups: patients undergoing immediate percutaneoustrans-

Safety, Efficacy, and Cost Advantages of Combined Coronary Angiography and Angioplasty

“…In our study, the combined procedure did not increase the risk of complications or procedural failure even in the high risk subgroups. As previously reported 5 it appears highly possible to perform the combined approach safely in most patients requiring angioplasty.…”

“…Furthermore, this approach shows consistent economic advantages compared to the staged strategy, by reducing the length of hospital stay. Previous reports [1][2][3][4][5][6][7]12,13 have demonstrated that the performance of angioplasty at the time of initial catheterization did not affect procedural morbidity and mortality, shortened the length of hospitalization by 30%, and reduced the total cost of the procedure by 15%. However, it has recently been written that a small increment in complications would cancel the cost savings of the shortened hospitalization time.…”

“…Previous reports 1–6 have suggested that coronary angioplasty (PTCA) can be successfully performed during the same setting as diagnostic coronary angiography with low complication rates similar to those observed in the conventional staged procedure. The combined angiography and PTCA approach may also reduce patient exposure to radiation and avoid the complications associated with a second procedure 7 .…”

Outpatient coronary angiography: Indications, safety, and complication rates

“…Table 1 outlines the general criteria for exclusion from ambulatory catheterization as defined by the American College of Cardiology/American Heart Association Ad Hoc Task Force Report [29]. Although the criteria exclude percutaneous transluminal angioplasty, additional study suggests that immediate angioplasty can be carried out safely in selected patients [7,27]. Our own experience at Columbia Medical Center in Phoenix indicates that outpatient angioplasty is successful in low-risk patients.…”

Cardiac catheterization laboratory inpatient forecast tool: a prospective evaluation

“…3,4 Thus, prior to catheterization, it is often unknown whether a patient's post-procedure condition will require an inpatient overnight stay. 5,6 Uncertainty regarding hospital admissions from catheterization laboratories challenges efficient inpatient bed management. 6 Cardiology hospital units contain specialized monitoring equipment (eg, telemetry beds) designed for recovering catheterization patients, in addition to cardiac patients admitted from the emergency department (ED) and external locations (ie, direct admissions).…”