Same-Day Discharge After Percutaneous Coronary Intervention: Current Perspectives and Strategies for Implementation

JAMA Cardiol. 2016 May 1;1(2):216-23. doi: 10.1001/jamacardio.2016.0148.

Abstract

Importance: The evolution of percutaneous coronary intervention (PCI) has led to improved safety and efficacy, such that overnight observation can be avoided in some patients. We sought to provide a narrative review of the current literature regarding the outcomes of same-day discharge (SDD) PCI and to describe a framework for the development of an SDD program.

Observations: A literature search of PubMed was performed for human studies on SDD PCI published in English from January 1, 1995, to July 31, 2015. We reviewed the studies between June and September 2015. After literature review, we included reports of randomized clinical trials, observational studies, meta-analyses guidelines, and consensus statements in a narrative review. Compared with overnight observation, there was no increase in adverse events (bleeding, repeat coronary procedures, death, or rehospitalization) among patients in these studies who were discharged on the same day of their PCI procedure. Same-day discharge was associated with significant cost savings and was preferred by patients.

Conclusions and relevance: The available evidence supports the safety of SDD in selected patients after PCI. Specific programmatic features are important to the successful implementation of SDD after PCI. Greater adoption of SDD programs after PCI has the potential to improve patient satisfaction, increase bed availability, and reduce hospital costs without increasing adverse patient outcomes.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Cost Savings / economics
  • Hemorrhage / complications
  • Hemorrhage / epidemiology
  • Humans
  • Length of Stay / economics
  • Meta-Analysis as Topic
  • Observational Studies as Topic
  • Patient Discharge / economics
  • Patient Discharge / standards*
  • Patient Satisfaction / statistics & numerical data
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / economics
  • Percutaneous Coronary Intervention / methods*
  • Percutaneous Coronary Intervention / standards
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / therapeutic use
  • Randomized Controlled Trials as Topic
  • Time Factors
  • Treatment Outcome
  • United States

Substances

  • Platelet Aggregation Inhibitors