Taxiarchi, P, Martin, G, Curzen, N, Kinnaird, T, Ludman, P, Johnson, T, Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Rashid, M ORCID: https://orcid.org/0000-0001-9725-1583, Kontopantelis, E and Mamas, M ORCID: https://orcid.org/0000-0001-9241-8890 (2020) Rotational atherectomy and same day discharge: safety and growth from a national perspective. Catheterization and Cardiovascular Interventions.

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Abstract

Objectives
We explore whether same day discharge (SDD) is a feasible and safe practice following rotational atherectomy (ROTA) treatment during elective percutaneous coronary intervention (PCI), and examine which baseline characteristics are independently associated with SDD.
Background
SDD following elective ROTA PCI is not recommended as per the recent SCAI consensus. However, reports show it is practiced and no previous study has evaluated its safety and feasibility.
Methods
Our dataset included 4,591 patients undergoing elective ROTA PCI in England & Wales within an 8-years period. Independent associations with SDD were quantified via a multiple logistic regression model and the BCIS 30-day mortality risk model was used to evaluate the safety of SDD.
Results
The majority of elective ROTA PCI cases remain at the hospital for overnight (ON) observation, although SDD rates increased substantially from 6.7% in 2007 to 35.5% in 2014. The use of glycoprotein IIb/IIIa antagonists, Q wave AMI, left main PCI and valvular heart disease were independently associated with ON, while patients operated underwent transradial PCI were more likely to be SDD (OR=1.77, 95% CI [1.45-2.15]). Over the study period, observed mortality rates were not significantly higher than those expected from the BCIS risk model.
Conclusions
Our findings did not show superiority of the ON strategy over SDD for higher risk cases undergoing elective ROTA PCI, in terms of 30-day mortality. This is the first study to examine the safety of SDD after elective ROTA PCI and more should follow.

Item Type: Article
Additional Information: The final accepted version of this article and all relevant information related to it can be found online at; https://onlinelibrary.wiley.com/doi/full/10.1002/ccd.29228
Uncontrolled Keywords: Rotational Atherectomy, elective Percutaneous Coronary Intervention, Same day discharge, Mortality
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RD Surgery > RD32 Operative surgery. Technique of surgical operations
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 06 Aug 2020 11:48
Last Modified: 16 Sep 2020 14:27
URI: https://eprints.keele.ac.uk/id/eprint/8479

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