المؤلفون: Taxiarchi P; Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK., Kontopantelis E; Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK., Kinnaird T; University Hospital of Wales, Cardiff, UK., Curzen N; Coronary Research Group, University Hospital Southampton, Faculty of Medicine, University of Southampton, UK., Banning A; John Radcliffe Hospital, Oxford, UK., Ludman P; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK., Shoaib A; Keele Cardiovascular Research Group, Institute of Primary Care and Health Sciences, University of Keele and Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, UK., Rashid M; Keele Cardiovascular Research Group, Institute of Primary Care and Health Sciences, University of Keele and Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, UK., Martin GP; Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK., Mamas MA; Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Keele Cardiovascular Research Group, Institute of Primary Care and Health Sciences, University of Keele and Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, UK. Electronic address: doctorrashid7@gmail.com.

المصدر: International journal of cardiology [Int J Cardiol] 2020 Dec 15; Vol. 321, pp. 38-47. Date of Electronic Publication: 2020 Jul 30.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8200291 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1874-1754 (Electronic) Linking ISSN: 01675273 NLM ISO Abbreviation: Int J Cardiol Subsets: MEDLINE

مواضيع طبية MeSH: Coronary Artery Disease*/diagnostic imaging , Coronary Artery Disease*/surgery , Percutaneous Coronary Intervention*/adverse effects, England/epidemiology ; Humans ; Length of Stay ; Patient Discharge ; Risk Factors ; Time Factors ; Treatment Outcome ; Wales/epidemiology

مستخلص: Background: This study sought to investigate the safety and feasibility of same day discharge (SDD) practice and compare clinical outcomes to patients admitted for overnight stay (ON) undergoing elective left main stem (LMS) percutaneous coronary intervention (PCI). ON observation is still widely practiced in highly complex PCI as the standard of care, with no previous data comparing clinical outcomes in patients undergoing LMS PCI.
Methods: We analysed 6452 patients undergoing elective LMS PCI between 2007 and 2014 in England and Wales. Multiple logistic regressions and the BCIS risk model were used to study association between SDD and 30 day mortality.
Results: SDD rates almost doubled from 19.9% in 2007 to 39.8% in 2014 for all LMS procedures and increased from 20.7% to 41.4% for unprotected LMS cases during the same study period. There was a significant increase in procedural complexity with higher use of rotational atherectomy, longer stents and multivessel PCI. SDD was not associated with increased 30 day mortality (OR 0.70 95%CI 0.30-1.65) in the overall LMS PCI cohort and the results were similar in unprotected LMS (OR 0.48 95%CI 0.17-1.41) and those requiring ON stay (OR 0.58 95%CI 0.25-1.34).
Conclusions: We did not find evidence that SDD is not safe or feasible in highly complex LMS PCI procedures despite increasing procedural complexity with no significant increase in 30 day mortality rates.
Competing Interests: Declaration of Competing Interest All authors declare that there is no competing conflict of interest relevant to this study or any content presented in the manuscript.
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