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

Publication ,  Journal Article
Bradley, SM; Kaltenbach, LA; Xiang, K; Amin, AP; Hess, PL; Maddox, TM; Poulose, A; Brilakis, ES; Sorajja, P; Ho, PM; Rao, SV
Published in: JACC Cardiovasc Interv
August 9, 2021

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.

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Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

August 9, 2021

Volume

14

Issue

15

Start / End Page

1655 / 1666

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Registries
  • Percutaneous Coronary Intervention
  • Patient Discharge
  • Medicare
  • Length of Stay
  • Humans
  • Cross-Sectional Studies
  • Coronary Artery Disease
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bradley, S. M., Kaltenbach, L. A., Xiang, K., Amin, A. P., Hess, P. L., Maddox, T. M., … Rao, S. V. (2021). Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention. JACC Cardiovasc Interv, 14(15), 1655–1666. https://doi.org/10.1016/j.jcin.2021.05.043
Bradley, Steven M., Lisa A. Kaltenbach, Katelyn Xiang, Amit P. Amin, Paul L. Hess, Thomas M. Maddox, Anil Poulose, et al. “Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention.JACC Cardiovasc Interv 14, no. 15 (August 9, 2021): 1655–66. https://doi.org/10.1016/j.jcin.2021.05.043.
Bradley SM, Kaltenbach LA, Xiang K, Amin AP, Hess PL, Maddox TM, et al. Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention. JACC Cardiovasc Interv. 2021 Aug 9;14(15):1655–66.
Bradley, Steven M., et al. “Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention.JACC Cardiovasc Interv, vol. 14, no. 15, Aug. 2021, pp. 1655–66. Pubmed, doi:10.1016/j.jcin.2021.05.043.
Bradley SM, Kaltenbach LA, Xiang K, Amin AP, Hess PL, Maddox TM, Poulose A, Brilakis ES, Sorajja P, Ho PM, Rao SV. Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention. JACC Cardiovasc Interv. 2021 Aug 9;14(15):1655–1666.
Journal cover image

Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

August 9, 2021

Volume

14

Issue

15

Start / End Page

1655 / 1666

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Registries
  • Percutaneous Coronary Intervention
  • Patient Discharge
  • Medicare
  • Length of Stay
  • Humans
  • Cross-Sectional Studies
  • Coronary Artery Disease