{"id":12274,"date":"2011-10-04T16:07:11","date_gmt":"2011-10-04T20:07:11","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=12274"},"modified":"2011-10-04T16:09:09","modified_gmt":"2011-10-04T20:09:09","slug":"same-day-discharge-after-pci-safe-but-rarely-used","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/10\/04\/same-day-discharge-after-pci-safe-but-rarely-used\/","title":{"rendered":"Same-Day Discharge After PCI: Safe but Rarely Used"},"content":{"rendered":"<p>Same-day discharge after low-risk PCI is safe but only rarely used, according to a <a href=\"http:\/\/jama.ama-assn.org\/content\/306\/13\/1461.abstract\">study published in <em>JAMA<\/em><\/a>.<\/p>\n<p>Sunil Rao and colleagues analyzed data from\u00a0107,018 Medicare patients who underwent PCI at sites taking part in the CathPCI Registry. Only a small percentage (1.25%) \u00a0of patients in the study were discharged on the day of the procedure. These patients were similar to the patients with overnight stays, although same-day patients had shorter procedures, had fewer multivessel procedures, were more likely to have procedures using a transradial approach, \u00a0and were more likely to receive a vascular closure device. Same-day discharge patients also had\u00a0less hypertension and dyslipidemia. In addition, they were less likely to receive GP IIb\/IIIa inhibitors or bivalirudin.<\/p>\n<p>Rates of death or rehospitalization at 2 days or at 30 days did not differ significantly between patients discharged on the same day and those discharged after an overnight stay:<\/p>\n<ul>\n<li>2 days: 0.37% in the same-day group and 0.50% in the overnight group (p=0.51)<\/li>\n<li>30 days: 9.63% and 9.70% (p=0.94).<\/li>\n<\/ul>\n<p>For both groups, the median time to death or rehospitalization was almost the same (13 days in the same-day group, 14 days in the overnight group).<\/p>\n<p>One &#8220;nonclinical\u00a0reason&#8221; for the low rate of same-day discharge is that inpatient PCI is reimbursed at a higher rate than outpatient PCI, the authors note.\u00a0The study results, they write,\u00a0&#8220;suggest that a proportion of low-risk patients currently observed overnight may be eligible for same-day discharge without an increase in early or intermediate-term adverse events.&#8221;<\/p>\n<p><em>Our Interventional Cardiology moderators, Rick Lange and David Hillis, pose some thoughtful questions about the implications of this study <a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/interventional\/is-%E2%80%9Cstent-and-send%E2%80%9D-safe-for-older-patients\/\">here<\/a>. Take a look, then tell them what you think.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Same-day discharge after low-risk PCI is safe but only rarely used, according to a study published in JAMA. Sunil Rao and colleagues analyzed data from\u00a0107,018 Medicare patients who underwent PCI at sites taking part in the CathPCI Registry. Only a small percentage (1.25%) \u00a0of patients in the study were discharged on the day of the [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[1005,372],"class_list":["post-12274","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology","tag-early-discharge","tag-elective-pci"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/12274","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=12274"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/12274\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=12274"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=12274"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=12274"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}