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Should interventional cardiac catheterization procedures take place at the time of diagnostic procedures?
1University of Missouri-Columbia, 65212, USA.
Insights
Performing same-day cardiac catheterization and intervention is safe, successful, and significantly reduces hospital stay and costs. This strategy offers a cost-effective approach to cardiac care.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Economics
Background:
- Delayed interventional procedures after diagnostic cardiac catheterization increase hospital stays and costs.
- Limited data compare outcomes and costs of same-day versus delayed interventions.
Purpose of the Study:
- To evaluate the safety and success of performing interventional procedures on the same day as diagnostic cardiac catheterization.
- To quantify hospital cost savings associated with same-day intervention strategy.
Main Methods:
- Retrospective review of 357 consecutive patients undergoing elective native coronary artery intervention.
- Comparison of same-day (n=244) versus delayed (n=113) procedures.
- Analysis of procedural success, major complications, hospital days, and costs.
Main Results:
- No significant differences in patient demographics, risk factors, or lesion complexity between groups.
- Same-day intervention resulted in significantly shorter hospital stays (4.37 vs. 6.55 days) and lower procedural charges ($8,207.99 vs. $10,581.87).
- P-values < 0.0001 for both hospital stay and cost differences.
Conclusions:
- Same-day cardiac catheterization and intervention are as safe and successful as delayed procedures.
- This strategy significantly reduces hospital stay and associated costs.
- Same-day intervention is a cost-effective practice in cardiac catheterization laboratories.
Background:
In many cardiac catheterization laboratories interventional procedures are performed at a date later than the diagnostic study, causing increased hospital days and costs. Few data exist which compare procedural success, complications, and costs between procedures performed at the time of diagnostic study and those performed later.
Hypothesis:
The purpose of this study was to evaluate the safety and success of same-day interventional procedures and to quantitate hospital cost savings with this strategy.
Method:
In all, 357 consecutive patients who underwent an elective interventional procedure of a native coronary artery either at the time of diagnostic study (same day, n = 244) or later (delayed, n = 113) were reviewed. Procedural success [< 30% residual lesion post-percutaneous transluminal coronary angioplasty (PTCA) or 0% residual lesion post-stent], major complications [death, emergent coronary artery bypass grafting (CABG), myocardial infarction, and ventricular fibrillation], hospital days, and costs were analyzed. Procedural expense, including the diagnostic and interventional procedure in the cardiac catheterization laboratory, and hospital expense were analyzed.
Results:
Both groups were similar in terms of age, gender, coronary risk factors, indications (myocardial infarction, unstable angina, abnormal stress test), the culprit coronary artery, type of intervention (PTCA, stent), and lesion complexity (type A, B, C). The average hospital stay for the two groups was 4.37 +/- 2 and 6.55 +/- 2.4 days, respectively (p < 0.0001). The procedural charges were $8,207.99 and 10,581.87, respectively (p < 0.0001).
Conclusion:
Catheter intervention performed at the same time as the diagnostic cardiac catheterization procedure is as successful and as safe as that performed at a later date. Hospital stay and costs, as well as procedural expenses are significantly reduced by this practice.