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December 23, 2016Indian Heart JournalOpen Access

Baseline and procedural factors, including use of a femoral closure device (OR 4.88) and creatinine clearance >60 mL/min (OR 3.44), significantly predicted same-day discharge after elective percutaneous coronary intervention.

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Why the study?

What patient and procedural factors predict same-day discharge versus overnight stay in patients undergoing elective percutaneous coronary intervention?

Population

567 patients who underwent an elective percutaneous coronary intervention procedure as outpatients at a…

Comparison

Same-day discharge following elective… vs Overnight stay following elective percutaneous…

Design

Cohort

Key result

Baseline and procedural factors, including use of a femoral closure device (OR 4.88) and creatinine clearance >60 mL/min (OR 3.44), significantly predicted same-day discharge after elective percutaneous coronary intervention.

Authors

FGFrancis D. GrazianoSBSandeep BangaDBDenise Busman

Discussion

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Overview

May inform selection for same-day discharge after elective PCI; leaves open need for randomized validation.

Study Design

Type

Cohort (n=567)

Multicenter

No

Structured PICO

What patient and procedural factors predict same-day discharge versus overnight stay in patients undergoing elective percutaneous coronary intervention?

P
Population
567 patients who underwent an elective percutaneous coronary intervention (PCI) procedure as outpatients at a single center in Michigan, United States (n=345 admitted for overnight stay, n=222 discharged same day).
I
Intervention
Same-day discharge (SDD) following elective percutaneous coronary intervention
C
Comparator
Overnight stay (OS) following elective percutaneous coronary intervention
O
Outcome
Predictors of length of stay (overnight stay vs. same-day discharge)

Main Result

Effect estimate: OR 4.883 (95% CI 3.018-7.903)

p-value: p=<0.0001

Pre-, peri-, and post-procedural factors, including creatinine clearance, number of stents, use of closure devices, and angiographic results, significantly predict whether patients can be safely discharged the same day after elective PCI.

Limitations

  • Retrospective nature of the study prevented collection of certain data such as social support.
  • Associations identified do not necessarily give the direct reason for patient admission or same-day discharge.
  • Relatively small sample size from a single center limits generalizability.
  • Retrospective nature limited collection of certain data like social support
  • Associations do not give direct reasons for patient admission or SDD
  • Relatively small sample size
  • Single-center study limits generalizability

Cite This Study

Graziano et al. (2016) conducted a cohort in Elective Percutaneous Coronary Intervention (n=567). Same-day discharge predictors (e.g., femoral closure device) vs. Overnight stay predictors (e.g., manual compression) was evaluated on Same-day discharge (femoral closure device vs manual compression) (OR 4.883, 95% CI 3.018-7.903, p=<0.0001). Baseline and procedural factors, including use of a femoral closure device (OR 4.88) and creatinine clearance >60 mL/min (OR 3.44), significantly predicted same-day discharge after elective percutaneous coronary intervention.

synapsesocial.com/papers/6a156c1e5347fbb1739fc322https://doi.org/10.1016/j.ihj.2016.11.323
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