Cargando…
Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study
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 h...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414966/ https://www.ncbi.nlm.nih.gov/pubmed/28460770 http://dx.doi.org/10.1016/j.ihj.2016.11.323 |
_version_ | 1783233437907288064 |
---|---|
author | Graziano, Francis D. Banga, Sandeep Busman, Denise K. Muthusamy, Purushothaman Wohns, David H. |
author_facet | Graziano, Francis D. Banga, Sandeep Busman, Denise K. Muthusamy, Purushothaman Wohns, David H. |
author_sort | Graziano, Francis D. |
collection | PubMed |
description | 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 60 mL/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. |
format | Online Article Text |
id | pubmed-5414966 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-54149662018-03-01 Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study Graziano, Francis D. Banga, Sandeep Busman, Denise K. Muthusamy, Purushothaman Wohns, David H. Indian Heart J Original Article 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 60 mL/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. Elsevier 2017 2016-12-22 /pmc/articles/PMC5414966/ /pubmed/28460770 http://dx.doi.org/10.1016/j.ihj.2016.11.323 Text en © 2016 Published by Elsevier B.V. on behalf of Cardiological Society of India. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Graziano, Francis D. Banga, Sandeep Busman, Denise K. Muthusamy, Purushothaman Wohns, David H. Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study |
title | Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study |
title_full | Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study |
title_fullStr | Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study |
title_full_unstemmed | Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study |
title_short | Barriers to Early Discharge after Elective Percutaneous Coronary Intervention (BED PCI): A Single-Center Study |
title_sort | barriers to early discharge after elective percutaneous coronary intervention (bed pci): a single-center study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414966/ https://www.ncbi.nlm.nih.gov/pubmed/28460770 http://dx.doi.org/10.1016/j.ihj.2016.11.323 |
work_keys_str_mv | AT grazianofrancisd barrierstoearlydischargeafterelectivepercutaneouscoronaryinterventionbedpciasinglecenterstudy AT bangasandeep barrierstoearlydischargeafterelectivepercutaneouscoronaryinterventionbedpciasinglecenterstudy AT busmandenisek barrierstoearlydischargeafterelectivepercutaneouscoronaryinterventionbedpciasinglecenterstudy AT muthusamypurushothaman barrierstoearlydischargeafterelectivepercutaneouscoronaryinterventionbedpciasinglecenterstudy AT wohnsdavidh barrierstoearlydischargeafterelectivepercutaneouscoronaryinterventionbedpciasinglecenterstudy |