Same day discharge after elective PCI in the elderly with low risk parameters

Same day discharge after elective PCI in the elderly with low risk parameters

Same day discharge after elective PCI in the elderly with low risk parameters: Patients undergoing elective percutaneous coronary interventions (PCI) are observed at least overnight at the hospital. Same day discharge if feasible is a welcome option for the patient, especially in the elderly who are often afraid of staying in hospitals and intensive care units. This aspect was evaluated by Sunil V Rao, Lisa A Kaltenbach, William S Weintraub, Matthew T Roe, Ralph G Brindis, John S Rumsfeld and Eric D Peterson in a study published in the Journal of American Medical Association [1]. They screened data from over hundred thousand patients aged 65 years or more who underwent elective percutaneous coronary interventions at over nine hundred sites. These were from the CathPCI Registry between November 2004 and December 2008 and were linked with Medicare Part A claims.

They gathered 1339 patients with same day discharge after PCI which was a mere 1.25% of the total. Same day discharge patients had undergone less of multivessel intervention and had shorter procedure times. There was no significant difference in death rates or rehospitalization at two days for these patients compared to those who had overnight hospitalization. Nor was the thirty day death or rehospitalization different after adjustment for patient and procedure characteristics. Hence though rarely implemented, same day discharge after elective PCI in selected low risk patients is not associated with death or rehospitalization compared to those who had overnight observation.

Reference

1. Sunil V Rao, Lisa A Kaltenbach, William S Weintraub, Matthew T Roe, Ralph G Brindis, John S Rumsfeld, Eric D Peterson. Prevalence and Outcomes of Same-Day Discharge After Elective Percutaneous Coronary Intervention Among Older Patients. JAMA. 2011 Oct 5;306(13):1461-7.