Predictors of same day discharge after percutaneous coronary interventions

Michail Koutouzis; Maria Agelaki; Christos Maniotis; Panagiotis Dimitriou; Andreas Tsoulmeleas; Ioannis Matsoukis; Constantinos Andreou; Efstathios Lazaris

doi:10.1016/j.carrev.2017.01.003

Predictors of same day discharge after percutaneous coronary interventions

Cardiovasc Revasc Med. 2017 Jun;18(4):241-244. doi: 10.1016/j.carrev.2017.01.003. Epub 2017 Jan 8.

Authors

Michail Koutouzis¹, Maria Agelaki², Christos Maniotis², Panagiotis Dimitriou², Andreas Tsoulmeleas², Ioannis Matsoukis², Constantinos Andreou², Efstathios Lazaris²

Affiliations

¹ Second Cardiology Department, Hellenic Red Cross Hospital, Athens, Greece. Electronic address: koutouzismike@yahoo.gr.
² Second Cardiology Department, Hellenic Red Cross Hospital, Athens, Greece.

PMID: 28089776
DOI: 10.1016/j.carrev.2017.01.003

Abstract

Objectives: The aim of this study is to identify possible predictors for same day discharge (SDD) after percutaneous coronary interventions (PCI).

Background: Same day discharge after PCI is becoming more and more appealing and patient's selection criteria are being formulated.

Methods: A retrospective analysis was performed in all PCI procedures from January 2013 until December 2015. Patients were discharged the same day (SDD group) or had at least one overnight stay (non-SDD group). The decision of SDD or not was on treating physician discretion. We evaluated predictors of SDD decision by a logistic regression analysis.

Results: One thousand one hundred sixty eight procedures were performed from our department during the study period: 308 patients (26.4%) were discharged the same day (SDD group) and the rest 860 procedures (73.6%) had at least one overnight stay (non-SDD group). Multivariate analysis revealed that forearm approach (OR=5.498, CI: 2.067-14.629; p=<0.001), patient's residency proximal to the hospital (OR=4.543, CI: 2.406-8.580; p<0.001), completion of the procedure before 13,00p.m. (OR=3.437, CI: 1.789-0.6.601; p<0.001) and the success of the performed procedure (OR=1.125, CI 1.043-2.135; p=0.044) were positive predictors of SDD, while presentation with non-ST elevation myocardial infarction or unstable angina (OR=0.542, CI: 0.268-0.872; p<0.010) and amount of contrast used (OR=0.910, CI: 0.852-0.969; p<0.030) were negative predictors of SDD.

Conclusion: In retrospect, both procedural and demographic details play a crucial role in patient selection for same day discharge post coronary percutaneous intervention.

Keywords: Cad; PCI; Same day discharge.

MeSH terms

Aged
Chi-Square Distribution
Clinical Decision-Making
Coronary Artery Disease / diagnosis
Coronary Artery Disease / therapy*
Decision Support Techniques
Female
Humans
Logistic Models
Longevity*
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Patient Discharge*
Patient Selection
Percutaneous Coronary Intervention* / adverse effects
Predictive Value of Tests
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome