Transradial PCI and Same Day Discharge

Elfandi, Ali; Safirstein, Jordan

doi:10.1007/s11936-018-0605-3

Cited by 6 publications

(6 citation statements)

References 42 publications

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“…As of 2017, SDD after PCI was practiced routinely by 14% of cardiologists in the United States versus 32% of cardiologists from Canada ( p = 0.0003) and 57% ( p = 0.0001) from the United Kingdom 32 . Early ambulation and shorter recovery time following transradial PCI have facilitated SDD as an alternative to overnight hospitalization 6,10,11,33 . The advances in interventional and vascular access techniques, use of newer generation antiplatelet therapies, improved stent technology, availability of risk prediction models, and guideline recommendations in the last decade have made PCI safer 1,2,4‐9,12,27,34‐36 .…”

Section: Discussionmentioning

confidence: 99%

“…32 Early ambulation and shorter recovery time following transradial PCI have facilitated SDD as an alternative to overnight hospitalization. 6,10,11,33 The advances in interventional and vascular access techniques, use of newer generation antiplatelet therapies, improved stent technology, availability of risk prediction models, and guideline recommendations in the last decade have made PCI safer. 1,2,[4][5][6][7][8][9]12,27,[34][35][36] We found that 77.8% (n = 1633) of the PCIs performed between 2011 and 2017 met the high-risk definition.…”

Section: Adverse Eventsmentioning

confidence: 99%

“…Following elective uncomplicated PCI, patients are observed overnight to monitor for procedure-related complications. The safety and increased use of transradial PCI 6,10,11 has shifted this paradigm from next-day discharge (NDD) to sameday discharge (SDD). SDD has been demonstrated to be safe in selected low-risk PCI, [11][12][13] but adoption in clinical practice has been slow.…”

Section: Introductionmentioning

confidence: 99%

“…The safety and increased use of transradial PCI 6,10,11 has shifted this paradigm from next-day discharge (NDD) to sameday discharge (SDD). SDD has been demonstrated to be safe in selected low-risk PCI, [11][12][13] but adoption in clinical practice has been slow. In the United States, adoption of SDD is only 14%, compared to 30% in Canada 14 and 57% in the United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

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

Ginete

Groth

Rudeck

et al. 2023

Cathet Cardio Intervent

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Adverse Eventsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Ginete

Groth

Rudeck

et al. 2023

Cathet Cardio Intervent

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“…[4] Same day discharge (SDD) following elective PCI was successfully being carried out in several PCI capable centers across the globe. [5–6]…”

Section: Introductionmentioning

confidence: 99%

Early versus late clinical outcomes following same day discharge after elective percutaneous coronary intervention

Guan

Zhou

et al. 2019

Medicine

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Background:Nowadays 57% of the cardiologists based in the United Kingdom and 32% of the cardiologists based in Canada utilize same day discharge (SDD) following elective percutaneous coronary intervention (PCI) as a routine practice. In this analysis, we aimed to systematically assess early versus late clinical outcomes following SDD after elective PCI.Methods:The Medical Literature Analysis and Retrieval System Online, the Cochrane Central, the Resources from the United States National Library of Medicine (www.ClinicalTrials.gov: http://www.clinicaltrials.gov) and EMBASE were carefully searched for relevant English publications which reported early versus late clinical outcomes in patients who were discharged on the same day following revascularization by PCI. Relevant clinical outcomes which were reported in the original studies were considered as the endpoints in this analysis. Odd ratios (OR) and 95% confidence intervals (CI) were used to represent the data, and RevMan 5.3 was used as the statistical software.Results:A total number of 21, 687 participants (enrollment time period from the year 1998 to the year 2015) were assigned to this analysis. When early versus late clinical outcomes were compared in patients who were discharged on the same day following elective PCI, major adverse cardiac events (OR: 0.75, 95% CI: 0.31–1.79; P = .51), mortality (OR: 0.26, 95% CI: 0.06–1.06; P = .06), stroke (OR: 1.46, 95% CI: 0.72–2.94; P = .29), arrhythmia (OR: 1.30, 95% CI: 0.64–2.63; P = .47), hematoma (OR: 1.00, 95% CI: 0.60–1.66; P = 1.00) and major bleeding from access site (OR: 1.68, 95% CI: 0.22–12.85; P = .62) were not significantly different. Post-procedural myocardial infarction (OR: 2.01, 95% CI: 0.71–5.70; P = .19) and minor bleeding from access site (OR: 6.61, 95% CI: 0.86–50.66; P = .07) were also similarly manifested. However, re-hospitalization was significantly higher in those patients with late clinical outcomes (OR: 0.18, 95% CI: 0.07–0.44; P = .0002).Conclusions:In those patients who were discharged from the hospital on the same day following elective PCI, no significant difference was observed in the assessed early versus late clinical outcomes. However, late clinical outcomes resulted in a significantly higher rate of re-hospitalization. Larger studies should confirm this hypothesis.

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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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Transradial PCI and Same Day Discharge

Cited by 6 publications

References 42 publications

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

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

Early versus late clinical outcomes following same day discharge after elective percutaneous coronary intervention

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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