Key result
Same-day discharge after ICD placement for primary prevention was achieved in 78.6% of outpatients and was safe, with only 2% experiencing minor surgical site bleeding at 2 weeks.
Why the study?
Does same-day discharge after ICD placement for primary prevention of sudden cardiac death affect the rate of short-term surgical complications compared to inpatient admission?
Cohort (n=415)
Does same-day discharge after ICD placement for primary prevention of sudden cardiac death affect the rate of short-term surgical complications compared to inpatient admission?
Same-day discharge after ICD placement for primary prevention is safe and feasible, with low rates of short-term surgical complications.
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May support same-day ICD discharge in selected patients; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: In the current age of ever-increasing healthcare costs, it is of utmost importance to adopt strategies that reduce hospital stay and cost, while still maintaining patient safety. In this study we review our approach of same-day discharge following implantable cardioverter defibrillator (ICD) placement for primary prevention of sudden cardiac death (SCD). METHODS: We conducted a retrospective chart review of 415 consecutive patients who underwent ICD implantation for prevention of SCD between 2007 and 2010. Patients were divided into an outpatient group (Group A) and an inpatient group (Group B). We evaluated the patients' demographics, comorbidities, and the rate of short-term surgical complications on or before the 2-week follow-up appointment. RESULTS: Of 252 patients included in Group A, 198 (78.6%) were successfully discharged on the same day (Group A1). At the 2-week wound check appointment, four patients (2%) had minor surgical site bleeding, one patient had a hematoma, and one patient developed fever and swelling around the implantation site. Of the Group A patients, 54 (21.4%) were not discharged on the same day (Group A2). A total of 53 patients were included in Group B, four (7.5%) developed a hematoma at the 2-week follow-up wound check visit. CONCLUSIONS: Procedure-related complications after ICD placement are rare. Same-day discharge is safe and feasible following ICD placement for primary prevention of SCD and hence a reduction in healthcare costs can be achieved by decreasing the length of hospital stay.
Darda et al. (2013) conducted a cohort in Primary prevention of sudden cardiac death (n=415). Same-day discharge following ICD placement vs. Inpatient admission was evaluated on Short-term surgical complications on or before the 2-week follow-up appointment. Same-day discharge after ICD placement for primary prevention was achieved in 78.6% of outpatients and was safe, with only 2% experiencing minor surgical site bleeding at 2 weeks.