المؤلفون: Graziano FD; Spectrum Health, Grand Rapids, MI, USA., Banga S; Frederik Meijer Heart & Vascular Institute, Grand Rapids, MI, USA; University of Illinois College of Medicine at Peoria, Peoria, IL, USA. Electronic address: drsbanga@uicomp.uic.edu., Busman DK; Frederik Meijer Heart & Vascular Institute, Grand Rapids, MI, USA; Spectrum Health, Grand Rapids, MI, USA., Muthusamy P; Frederik Meijer Heart & Vascular Institute, Grand Rapids, MI, USA., Wohns DH; Frederik Meijer Heart & Vascular Institute, Grand Rapids, MI, USA; Spectrum Health, Grand Rapids, MI, USA.

المصدر: Indian heart journal [Indian Heart J] 2017 Mar - Apr; Vol. 69 (2), pp. 217-222. Date of Electronic Publication: 2016 Dec 22.

نوع المنشور: Comparative Study; Journal Article

بيانات الدورية: Publisher: Elsevier Country of Publication: India NLM ID: 0374675 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-3763 (Electronic) Linking ISSN: 00194832 NLM ISO Abbreviation: Indian Heart J Subsets: MEDLINE

مواضيع طبية MeSH: Risk Assessment*, Coronary Artery Disease/*surgery , Elective Surgical Procedures/*methods , Patient Discharge/*trends , Percutaneous Coronary Intervention/*methods, Aged ; Coronary Artery Disease/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Time Factors ; Treatment Outcome

مستخلص: Objective: To identify patient characteristics and procedural factors that may play a role in hindering same-day discharge (SDD) practices.
Background: Multiple studies have shown the safety and cost effectiveness of SDD following elective percutaneous coronary intervention (PCI), but factors that hinder SDD practices have not been thoroughly studied.
Material and Methods: A retrospective comparative analysis of elective PCI patients who had an overnight stay (OS) (n=345) vs. SDD patients (n=222) was conducted to identify significant differences between the two groups in baseline patient characteristics, procedural, and postprocedural factors.
Results: Comparing OS to SDD patients, OS patients had a lower prevalence of radial access (20.29% vs. 39.64%, P<0.0001); a higher incidence of suboptimal angiographic results (14.49% vs. 1.80%, P=0.0027); CRCL values lower than 60mL/min (26.38% vs. 15.32%, P=0.0019); and greater femoral vascular site hemostasis with manual compression (69.09% vs. 36.57%, P=0.0027). OS patients received larger sheath sizes (P=0.0209), more bivalirudin (45.80% vs. 36.70%) and glycoprotein IIb/IIIa inhibitors (5.51% vs. 2.25%), but less heparin (51.30% vs. 53.21%). Chest pain (8.12% vs. 0.92%, P=0.0042) and vascular access site concerns (20.58% vs. 0%, P=0.0027) were more common among OS patients.
Conclusions: Pre-, peri-, and post-procedural factors play a role in SDD eligibility. Understanding factors that limit as well as those that facilitate SDD may enable institutions to establish or enhance a SDD program.
(Copyright © 2016. Published by Elsevier B.V.)