Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention

Steven M. Bradley, Lisa A. Kaltenbach, Katelyn Xiang, Amit P. Amin, Paul L. Hess, Thomas M. Maddox, Anil Poulose, Emmanouil S. Brilakis, Paul Sorajja, P. Michael Ho, Sunil V. Rao

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: The aims of this study were to describe trends and hospital variation in same-day discharge following elective percutaneous coronary intervention (PCI) and to evaluate the association between trends in same-day discharge and patient outcomes. Background: Insights on contemporary use of same-day discharge following elective PCI are limited. Methods: In a sequential cross-sectional analysis of 819,091 patients undergoing elective PCI at 1,716 hospitals in the National Cardiovascular Data Registry CathPCI Registry from July 1, 2009, to December 31, 2017, overall and hospital-level trends in same-day discharge were assessed. Among the 212,369 patients who linked to Centers for Medicare and Medicaid Services data, the association between same-day discharge and 30-day mortality and rehospitalization was assessed. Results: A total of 114,461 patients (14.0%) were discharged the same day as PCI. The proportion of patients with same-day discharge increased from 4.5% in the third quarter of 2009 to 28.6% in the fourth quarter of 2017. From 2009 to 2017, the rate of same-day discharge increased from 4.3% to 19.5% for femoral-access PCI and from 9.9% to 39.7% for radial-access PCI. Hospital-level variation in the use of same-day discharge persisted throughout (median odds ratio adjusted for year and radial access: 4.15). Risk-adjusted 30-day mortality did not change over time, while risk-adjusted rehospitalization decreased over time and more quickly for same-day discharge (P for interaction <0.001). Conclusions: In the past decade, a large increase in the use of same-day discharge following elective PCI was not associated with worse 30-day mortality or rehospitalization. Hospital-level variation in same-day discharge may represent an opportunity to reduce costs without compromising patient outcomes.

Original languageEnglish
Pages (from-to)1655-1666
Number of pages12
JournalJACC: Cardiovascular Interventions
Volume14
Issue number15
DOIs
StatePublished - Aug 9 2021

Keywords

  • elective surgical procedures
  • length of stay
  • patient discharge
  • percutaneous coronary intervention
  • registries

Fingerprint

Dive into the research topics of 'Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention'. Together they form a unique fingerprint.

Cite this