Taxiarchi, P, Kontopantelis, E, Kinnaird, T, Curzen, N, Banning, A, Ludman, P, Shoaib, A, Rashid, M ORCID: https://orcid.org/0000-0001-9725-1583, Martin, GP and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2020) Adoption of same day discharge following elective left main stem percutaneous coronary intervention. International Journal of Cardiology.

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Abstract

BACKGROUND: This study sought to investigate the safety and feasibility of same day discharge (SDD) practice and compare clinical outcomes to patients admitted for overnight stay (ON) undergoing elective left main stem (LMS) percutaneous coronary intervention (PCI). ON observation is still widely practiced in highly complex PCI as the standard of care, with no previous data comparing clinical outcomes in patients undergoing LMS PCI. METHODS: We analysed 6452 patients undergoing elective LMS PCI between 2007 and 2014 in England and Wales. Multiple logistic regressions and the BCIS risk model were used to study association between SDD and 30 day mortality. RESULTS: SDD rates almost doubled from 19.9% in 2007 to 39.8% in 2014 for all LMS procedures and increased from 20.7% to 41.4% for unprotected LMS cases during the same study period. There was a significant increase in procedural complexity with higher use of rotational atherectomy, longer stents and multivessel PCI. SDD was not associated with increased 30 day mortality (OR 0.70 95%CI 0.30-1.65) in the overall LMS PCI cohort and the results were similar in unprotected LMS (OR 0.48 95%CI 0.17-1.41) and those requiring ON stay (OR 0.58 95%CI 0.25-1.34). CONCLUSIONS: We did not find evidence that SDD is not safe or feasible in highly complex LMS PCI procedures despite increasing procedural complexity with no significant increase in 30 day mortality rates.

Item Type: Article
Additional Information: The final version of this article and all relevant information related to it can be found at; https://www.sciencedirect.com/science/article/pii/S0167527320334860?via%3Dihub#!
Uncontrolled Keywords: Elective percutaneous coronary intervention, Same day discharge, Mortality, Outcomes
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 14 Aug 2020 14:40
Last Modified: 14 Aug 2020 14:40
URI: https://eprints.keele.ac.uk/id/eprint/8549

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