Outcomes and safety of same-day discharge after percutaneous coronary intervention: A 10-year single-center study

Autor: Philippe Le Corvoisier, Servais Akakpo, Vladimir Rubimbura, Emmanuel Teiger, Abdelkaoui Belarbi, Laura Rostain, Philippe Boiron, Duval Am, Gauthier Mouillet, Madjid Boukantar, Romain Gallet, Jean-Luc Dubois-Randé
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Time Factors
Databases
Factual
medicine.medical_treatment
Coronary Artery Disease
030204 cardiovascular system & hematology
Chest pain
Single Center
Patient Readmission
Risk Assessment
03 medical and health sciences
Hospitals
Urban
Percutaneous Coronary Intervention
0302 clinical medicine
Risk Factors
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Adverse effect
Stroke
Aged
Retrospective Studies
business.industry
Percutaneous coronary intervention
General Medicine
Length of Stay
Middle Aged
medicine.disease
Patient Discharge
Outcome and Process Assessment
Health Care
Treatment Outcome
surgical procedures
operative
Ambulatory
Conventional PCI
Emergency medicine
Female
France
Patient Safety
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Hospitals
High-Volume
Zdroj: Catheterization and Cardiovascular Interventions. 94:105-111
ISSN: 1522-1946
DOI: 10.1002/ccd.28084
Popis: Aims Same-day discharge (SDD) after percutaneous coronary intervention (PCI) was safe and cost-effective in randomized and observational studies but faces limited acceptance due to concerns about early adverse events. Our aim was to evaluate early outcomes after SDD PCI in a high-volume urban PCI center over 10 years. Methods and results From 2007 to 2016, 1,635 unselected patients had PCI at our ambulatory cardiac care unit, mainly for stable ischemic heart disease (SIHD). Among them, 1,073 (65.6%), most of whom underwent ad hoc PCI, were discharged on the same day and 562 (34.4%) were admitted, for adverse events during PCI (n = 60) or within the next 4-6 hr (n = 52) or chiefly due to physician preference (n = 450). In the SDD group, radial access was used in 98.5% of patients; 36% and 15% of patients had two- and three-vessel disease, respectively; and two-vessel PCI was performed in 11% of patients. No MACCEs (death, myocardial infarction, stroke, urgent repeat PCI/CABG, and major vascular complications) occurred within 24 hr post-discharge. Two patients were readmitted on the next day for chest pain but did not require repeat PCI. Conclusion SDD after successful PCI without complications within the next 4-6 hr is safe and feasible in most patients with SIHD. Among 1,035 SDD patients treated over 10 years, only two required readmission, and none experienced major cardiac adverse events such as death or stent thrombosis. SDD is safe for the patient and cost-effective for the healthcare system and should be implemented more widely.
Databáze: OpenAIRE
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