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

Abstract

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.

Ambulatory Percutaneous Coronary Angioplasty: a safe resource for low income countries

“…In 2020, the Society for Cardiovascular Angiography and Interventions (SCAI) finally endorsed PCIa, if quality and safety standards in ambulatory surgical centers (ASCs) matched those in hospitals [10,11]. While PCIa may already be occurring in some parts of Latin America and the Caribbean, like Trinidad and Tobago, showing procedural success rates with no major early complications and the potential for in-hospital savings of up to $1480 USD per patient [12], the available information remains limited. The Dominican Republic (DR), for instance, has yet to undertake any studies on this procedure.…”

Same-day discharge percutaneous coronary intervention. Where are we?

“…5,6 Different series globally have evaluated SDD after elective PCI. [7][8][9][10] There is a natural movement of migration towards the use of this care strategy, and its adoption has been accelerated due to the recent 2019 coronavirus disease (COVID-19) pandemic. 11 The SDD protocol-eligible patient profile must follow certain requirements, which are described in two main guidelines.…”