Safety of same-day discharge versus overnight stay strategy following cardiac device implantations: a high-volume single-centre experience

BACKGROUND: The strategy of cardiac implantable electronic device (CIED) implantations performed as day-case admissions has gained a wider acceptance overtime; however, data on safety are still limited. This study aims to investigate the safety of a same-day discharge protocol introduced in our hosp...

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Detalles Bibliográficos
Autores principales: Archontakis, Stefanos, Oikonomou, Evangelos, Sideris, Konstantinos, Laina, Ageliki, Tirovola, Dimitra, Paraskevopoulou, Dimitra, Kostakis, Panagiotis, Doundoulakis, Ioannis, Arsenos, Petros, Ntalakouras, Ioannis, Charitakis, Emmanouil, Gatzoulis, Konstantinos, Tsioufis, Konstantinos, Sideris, Skevos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9442569/
https://www.ncbi.nlm.nih.gov/pubmed/36063282
http://dx.doi.org/10.1007/s10840-022-01319-5
Descripción
Sumario:BACKGROUND: The strategy of cardiac implantable electronic device (CIED) implantations performed as day-case admissions has gained a wider acceptance overtime; however, data on safety are still limited. This study aims to investigate the safety of a same-day discharge protocol introduced in our hospital for the postprocedural management of patients undergoing CIED implantation. METHODS: Α prospective, non-interventional, non-randomised study performed in a single high-volume implanting centre for a 16-month period (March 2020 to June 2021). At total of 821 of 965 (85.1%) patients scheduled for elective CIED implantation were considered to be eligible for inclusion in the Short-stay Device Management Protocol. These patients were compared with a historical group of 932 patients, meeting the same inclusion criteria. RESULTS: Procedure was successful in 812 patients (98.9%), committed to same-day discharge versus 921 of 932 patients (98.8%) admitted for overnight stay (p = 0.87). Overall, 90-day complication rate was comparable in both groups (4.14% vs 4.07%, p = 0.95), as was major (1.46% vs. 1.82%, p = 0.55) and minor (2.67% vs. 2.25%, p = 0.64) complication rates. The composite early post-procedural complication rates and late post-procedural complication rates were comparable among groups (0.97 vs 1.18%, p = 0.70 and 0.73% vs 0.64%, p = 0.83, respectively). Six hundred sixty-seven patients (84%) preferred the same-day discharge strategy. Finally, a reduction of 792 bed-days was recorded, resulting in possible financial Health System benefits. CONCLUSIONS: Same-day discharge is feasible and safe in the majority of patients referred for CIED implantation. Additionally, same-day discharge is preferred by patients and may reduce procedure-related costs due to significant bed-day reductions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10840-022-01319-5.

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