Outcomes of same day discharge after percutaneous coronary intervention: A quality improvement project

Chen, Yingyan; Marshall, Andrea P.; Lin, Frances

doi:10.1016/j.colegn.2020.08.003

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…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

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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.

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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

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Prevalence, trends, and outcomes of same-day discharge following elective percutaneous coronary intervention: a retrospective observational cohort study using routinely collected health data

Chen,

Smith,

et al. 2024

European Journal of Cardiovascular Nursing

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Aims To identify the prevalence, trends, and outcomes of same-day discharge following elective percutaneous coronary intervention among six public hospitals in one Australian State. Methods and results A retrospective observational research design was used. A total of 4387 cases were obtained from the State Cardiac Outcomes Registry and National Hospital Cost Data Collection. The two datasets were linked using identifiable data items. Patients were those who had elective percutaneous coronary intervention between December 2012 and December 2019 either discharged the same day of the procedure or the next day. Data were analysed using descriptive and inferential statistics. The overall same-day discharge prevalence was 6.5%, with a trend increasing from 0.2% in 2013 to 9.0% in 2019. The prevalence varied at the individual hospital level. Two hospitals did not perform same-day discharge during the study period. The remaining hospitals demonstrated variability in same-day discharge prevalence, with the highest from one hospital being 28.2% in 2019. Almost all same-day discharge patients experienced no complications during or following percutaneous coronary intervention within 24 hours. Compared to next-day discharge, same-day discharge reduced the length of stay by 18 hours and conferred an average of $3695 cost-savings per patient. Conclusions There was limited implementation of same-day discharge in the six public hospitals contributing data to this study. Improvement in the same-day discharge rate could result in better hospital resource utilisation and reduce low-value care. Hence, strategies to implement and promote same-day discharge are warranted.

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Outcomes of same day discharge after percutaneous coronary intervention: A quality improvement project

Cited by 2 publications

References 19 publications

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

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

Prevalence, trends, and outcomes of same-day discharge following elective percutaneous coronary intervention: a retrospective observational cohort study using routinely collected health data

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