Streamlining same-day discharge for percutaneous coronary intervention: a single-center experience

Abstract

Introduction and objectives

Same-day discharge (SDD) can be considered for patients who traditionally required overnight stay (ONS) after percutaneous coronary intervention (PCI). The authors aimed to evaluate viability of SDD-PCI.

Methods

Retrospective single-center observational study of patients who underwent elective PCI. SDD patients were selected based on clinical, angiographic, and sociodemographic characteristics. Patient and procedure characteristics were collected from local databases, and SDD-PCI adverse events (all-cause mortality, acute coronary syndrome, stent thrombosis, reintervention, major bleeding, stroke, contrast-induced renal failure, vascular access complications) at 30-days were analyzed.

Results

This study included 147 patients, 76% males with a mean age of 66 ± 10, that underwent elective PCI during the first year after implementation of SDD protocol. Most patients undergoing elective PCI were discharged the same day (n = 94, 64%). ONS group, when compared to SDD, had higher rates of acute coronary syndrome (38% vs 19%, P = .01) and left ventricular dysfunction (17% vs 6%, P = .04), higher Syntax I score (10 points [6–16] vs 8 points [5–12]; P = .01), more cases of multivessel PCI (24% vs 6%, P < .01) and a surrogate for longer procedures – fluoroscopy time (11 min [7–15] vs 8 min [5–13]; P = .02). There were no adverse events during the 30-day follow-up period of the patients treated in ambulatory regimen.

Conclusions

SDD-PCI is a safe procedure. Protocol implementation is key to guide interventional cardiologists in low-risk patient selection. The potential role in decreasing bed-shortage, hospital overcrowding, and healthcare costs is pivotal.