Outcomes of an expedited same-day discharge protocol following cardiac implantable electronic device (CIED) implantation.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-08-01 Epub Date: 2024-01-09 DOI:10.1007/s10840-024-01734-w

Satish Misra, Kamala Swayampakala, Aparna Rajwani, Elizabeth Davenport, John Fedor, Sherry Saxonhouse, John Holshouser, Neel Patel, Joseph Thompson, Elijah Beaty, Manish Jain, Brian Powell, Rohit Mehta

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引用次数: 0

Abstract

Background: With increasing constraints on healthcare resources, greater attention is being focused on improved resource utilization. Prior studies have demonstrated safety of same-day discharge following CIED implantation but are limited by vague protocols with long observation periods. In this study, we evaluate the safety of an expedited 2 hour same-day discharge protocol following CIED implantation.

Methods: Patients undergoing CIED implantation at three centers between 2015 and 2021 were included. Procedural, demographic, and adverse event data were abstracted from the electronic health record. Patients were divided into same-day discharge (SDD) and delayed discharge (DD) cohorts. The primary outcome was complications including lead malfunction requiring revision, pneumothorax, hemothorax, lead dislodgement, lead perforation with tamponade, and mortality within 30 days of procedure. Outcomes were compared between the two cohorts using the χ² test.

Results: A total of 4543 CIED implantation procedures were included with 1557 patients (34%) in the SDD cohort. SDD patients were comparatively younger, were more likely to be male, and had fewer comorbidities than DD patients. Among SDD patients, the mean time to post-operative chest X-ray was 2.6 h. SDD had lower rates of complications (1.3% vs 2.1%, p = 0.0487) and acute care utilization post-discharge (9.6% vs 14.0%, p < 0.0001). There was no difference in the 90-day infection rate between the cohorts.

Conclusions: An expedited 2 hour same-day discharge protocol is safe and effective with low rates of complications, infection, and post-operative acute care utilization.

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心脏植入式电子设备 (CIED) 植入术后当天快速出院方案的效果。

背景：随着医疗资源日益紧张，人们更加关注如何提高资源利用率。之前的研究已经证明了 CIED 植入术后当天出院的安全性，但受限于观察期较长的模糊方案。在本研究中，我们评估了 CIED 植入术后 2 小时快速当天出院方案的安全性：方法：纳入2015年至2021年期间在三个中心接受CIED植入术的患者。从电子病历中摘录了手术、人口统计学和不良事件数据。患者被分为当天出院（SDD）和延迟出院（DD）两组。主要结果是并发症，包括需要翻修的导联故障、气胸、血胸、导联脱落、导联穿孔伴填塞以及术后 30 天内的死亡率。采用χ2检验比较了两个组群的结果：结果：共纳入4543例CIED植入手术，SDD队列中有1557例患者（34%）。与DD患者相比，SDD患者更年轻，更可能是男性，合并症更少。在 SDD 患者中，术后胸部 X 光检查的平均时间为 2.6 小时。SDD 患者的并发症发生率（1.3% vs 2.1%，P = 0.0487）和出院后急性护理使用率（9.6% vs 14.0%，P 结论：SDD 患者的并发症发生率（1.3% vs 2.1%，P = 0.0487）和出院后急性护理使用率较低：快速 2 小时当天出院方案安全有效，并发症、感染和术后急症护理使用率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.