Same-Day Discharge Feasible in Select Cases of Elective PCI

For select low-risk older patients same-day discharge does not up death, rehospitalization

TUESDAY, Oct. 4 (HealthDay News) -- For select low-risk older patients undergoing elective percutaneous coronary intervention (PCI), same-day discharge is not correlated with an increase in death or rehospitalization rates at two and 30 days, compared with overnight observation, according to a study published in the Oct. 5 issue of the Journal of the American Medical Association.

Sunil V. Rao, M.D., from the Duke Clinical Research Institute in Durham, N.C., and colleagues evaluated the prevalence and outcomes of same-day discharge among 107,018 patients 65 years or older undergoing elective PCI in the United States. Data were collected from the CathPCI Registry (November 2004 to December 2008) and linked with Medicare Part A claims. Participants were categorized according to the length of stay after PCI (same-day or overnight), and outcomes of death or rehospitalization occurring within two days and by 30 days after PCI were calculated.

The investigators found that the prevalence of same-day discharge was 1.25 percent and varied significantly across facilities. Patient characteristics in the two groups were similar, but shorter procedures with less multivessel intervention were seen in same-day discharge patients. Death or rehospitalization rates at two days were not significantly different. For patients with adverse outcomes, there were no significant differences between the groups for median time to death or rehospitalization. Same-day discharge was not correlated with 30-day death or rehospitalization, after adjusting for patient and procedure characteristics.

"Older patients undergoing elective PCI are rarely discharged home the same day as the procedure," the authors write. "Data suggest that selected low-risk patients may be considered for same-day discharge."

Several of the study authors disclosed financial ties to the pharmaceutical industry.

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