Key result
Same day discharge following uncomplicated elective radial PCI was safe with no adverse events and yielded similar patient satisfaction compared to overnight hospitalization (SAQ satisfaction p=0.48).
Why the study?
Although same-day discharge after elective PCI reduces bed occupancy, early discharge may cause anxiety and dissatisfaction among patients.
Does same day discharge after elective radial PCI maintain patient satisfaction and safety compared to overnight hospitalization in patients with stable CAD?
RCT (n=82)
block randomized
No
Does same day discharge after elective radial PCI maintain patient satisfaction and safety compared to overnight hospitalization in patients with stable CAD?
Same-day discharge after uncomplicated elective radial PCI is safe and yields equivalent patient satisfaction and quality of life compared to overnight hospitalization.
Answers are grounded in this paper and cite their sources.
Supports same-day discharge after elective radial PCI in stable CAD; extends prior femoral-era observations to contemporary practice.
Background Earlier observations in the era of femoral procedures using warfarin as the anticoagulant agent have shown safety following same day discharge after elective percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD). Procedures have evolved with most European centres adopting radial procedures with corresponding improvement in technique and equipment. Adoption of “radial lounges” has improved and simplified the observation routines with early ambulation. Antiplatelet therapy has also become more efficacious. The safety of same day discharge has been demonstrated. The economic benefit of such a strategy is significant with reported cost reductions of approximately 50%. Patient reported satisfaction is also shown to be comparable to standard care. The current bed availability in health care facilities has made it a necessity to explore measures to reduce bed occupancy rates. Reduction in bed occupancy can further permit health personell to focus on other duties and obligations in wards with patients requiring hospitalization. Early discharge may cause anxiety and dissatisfaction among patients. Purpose The aim of our study was to evaluate safety and patient satisfaction of same discharge following uncomplicated elective radial access PCI. Methods Randomized controlled single center study. Eligible patients scheduled for elective PCI with radial access were prescreened following predefined inclusion and exclusion criteria. Health related quality of life instruments (HRQOL), Seattle Angina Questionnaire (SAQ), Short form 36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) were completed by the patients and received at base line and at 30 days post-procedure. All same day discharged patients were contacted by phone by a specialized study nurse the day after the procedure. Results 517 patients were screened between November 2015 and November 2018 and 82 patients with mean age of 65 years were block randomized post-procedure. 38 patients were randomized to same day discharge after 6 hours of observation and 44 patients to standard care group which necessitated an overnight hospitalization. 11 female patients and 71 male patients were included. No adverse events were registered in either group. No significant difference between groups were observed in the SAQ (treatment satisfaction score p=0.48, angina frequency scale p=0.58), SF-36 (SF vitality p=0.93) or HADS (HADS anxiety + depression p=0.15). Changes of HADS score Conclusions Discharge on the same day following uncomplicated PCI for stable angina is safe and patient health related quality of life instruments confirm that patients are equally satisfied with this new care strategy when compared to usual care. Acknowledgement/Funding Stavanger University Hospital
No takes yet. Share an insight, caveat, or question.
Bogale et al. (2019) conducted an RCT in stable angina undergoing uncomplicated elective radial access PCI (n=82). Same day discharge after 6 hours of observation vs. Standard care (overnight hospitalization) was evaluated on Safety (adverse events) and patient satisfaction (SAQ, SF-36, HADS) (p=0.48). Same day discharge following uncomplicated elective radial PCI was safe with no adverse events and yielded similar patient satisfaction compared to overnight hospitalization (SAQ satisfaction p=0.48).
Synapse has enriched 10 related papers. Consider them for comparative context: