Key result
A same-day discharge protocol after elective radial coronary procedures achieved a 78.5% discharge rate with no major complications, though unplanned overnight stays were more common in PCI patients (RR 6.2; 95% CI 3.9-9.9; P<0.001).
Why the study?
Does a same-day discharge protocol after radial lounge monitoring maintain safety and patient satisfaction in patients undergoing elective radial coronary angiography or PCI?
Cohort (n=312)
No
Does a same-day discharge protocol after radial lounge monitoring maintain safety and patient satisfaction in patients undergoing elective radial coronary angiography or PCI?
Relative Risk: 6.2 (95% CI 3.9–9.9)
p-value: p=<0.001
A same-day discharge protocol after elective radial coronary angiography or PCI using a radial lounge is safe, feasible, and associated with high patient satisfaction.
Supports same-day discharge feasibility after radial procedures; hypothesis-generating and should not yet change practice without randomized confirmation.
AIMS: The aim of the study was to retrospectively evaluate safety and patient satisfaction of same-day discharge after elective radial coronary angiography/percutaneous coronary intervention (PCI) after the implementation of a radial lounge facility. METHODS: All patients admitted to our radial lounge with a planned same-day discharge after an uncomplicated coronary angiography/PCI, having a co-living caregiver, were day enrolled in the study. Rates of same-day discharge, unplanned overnight stay, and in-hospital and first complications [death, myocardial infarction (MI), unplanned coronary angiography, access site hematoma, bleedings requiring hospitalization] were analysed; satisfaction was also evaluated through a questionnaire. RESULTS: From February 2015 to January 2016, 312 patients with a mean age of 66.6 ± 10.8 years were admitted to the radial lounge (coronary angiography, n = 232; PCIs, n = 80). Of them, 245 (78.5%) were discharged the same day. Mean radial lounge monitoring was 6:35 h (interquartile range 5:30-7:30 h). No episodes of death/MI/unplanned coronary angiography were observed both in same-day discharged and postponed patients. Reasons to postpone discharge were: PCI deemed to need prolonged monitoring in 31, patient's preference in 14, femoral shift in 13, surgery in four, chest pain in four, and bleeding in one. At day 1, 11 access site hematoma and one hospitalization for access site bleeding were reported. Patients reported complete satisfaction in 97% of cases. Unplanned overnight stay was common among PCIs patients (RR 6.2, 95% CI 3.9-9.9, P < 0.001). CONCLUSION: A low rate of minor complications was observed in elective radial coronary angiography and PCIs showing the feasibility and safety of the development of an institutional protocol for same-day discharge after the implementation of a radial lounge facility.
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Biasco et al. (2017) conducted a cohort in Elective radial coronary angiography or percutaneous coronary intervention (n=312). Same-day discharge protocol after radial lounge monitoring was evaluated on Rates of same-day discharge, unplanned overnight stay, and complications (RR 6.2, 95% CI 3.9-9.9, p=<0.001). A same-day discharge protocol after elective radial coronary procedures achieved a 78.5% discharge rate with no major complications, though unplanned overnight stays were more common in PCI patients (RR 6.2; 95% CI 3.9-9.9; P<0.001).
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