Same-day discharge or overnight stay after percutaneous coronary intervention: comparison of net adverse cardiovascular events

J Invasive Cardiol. 2014 May;26(5):204-8.

Abstract

Background: Same-day discharge after percutaneous coronary intervention (PCI), if achieved with acceptable safety, could result in greater patient satisfaction and potential cost savings. Comparative analyses reporting the safety outcomes of same-day discharge vs overnight stay after elective PCI are lacking.

Methods: Data of same-day discharge and overnight-stay patients undergoing elective PCI in a high-volume center were compared. We specifically evaluated the incidence of net adverse cardiovascular events (NACE; i.e., death, myocardial infarction, stroke, target vessel revascularization, vascular complication, and major bleeding) within 48 hours post index procedure among both groups and at 30 days.

Results: A total of 188 cases were evaluated, with 93 discharged the same day and 95 after overnight stay following elective PCI. Baseline characteristics were similar, except for older age (73.0 ± 7 years vs. 64.0 ± 12 years; P<.001), more prior PCI (49.5% vs. 34.7%; P<.001), and prior coronary artery bypass graft surgery (16.1% vs. 11.6%; P=.01) in the same-day discharge group. Procedural characteristics were similar in both groups. No significant difference in the NACE rate was found between the groups at 48 hours (0 [0%] vs. 2 [2.1%]; P=.25) or at 30 days (3 [3.2%] vs. 6 [6.3%]; P=.26).

Conclusion: In the population studied, same-day discharge after PCI is safe and feasible. Adequately powered randomized prospective studies are necessary to confirm these results.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / therapy*
  • Female
  • Hemorrhage / epidemiology
  • Humans
  • Incidence
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Patient Discharge*
  • Percutaneous Coronary Intervention* / adverse effects
  • Retrospective Studies
  • Stroke / epidemiology
  • Time Factors
  • Treatment Outcome