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Same day discharge after chronic total occlusion interventions: A single center experience
Michael Koutouzis1, Catherine Liontou1, Iosif Xenogiannis2
1Red Cross General Hospital, Athens, Greece.
Insights
Same day discharge (SDD) after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is feasible and safe for selected patients. This approach reduces hospitalization costs and improves patient comfort without compromising safety outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is linked to elevated complication rates and healthcare expenses.
- Reducing post-PCI hospitalization duration enhances patient comfort and supports cost-containment strategies.
Purpose of the Study:
- To evaluate the feasibility and safety of same-day discharge (SDD) following CTO PCI.
- To compare 30-day outcomes between SDD and non-SDD patients undergoing CTO PCI.
Main Methods:
- Retrospective analysis of 173 patients undergoing CTO PCI between January 2016 and June 2019.
- Comparison of 30-day major adverse cardiovascular events (MACE) between SDD and non-SDD groups.
- Analysis of patient characteristics and procedural factors associated with SDD.
Main Results:
- Fifty-one patients (30%) underwent SDD. SDD patients had lower rates of diabetes mellitus, hypertension, and acute coronary syndrome presentation.
- Forearm access was utilized in all SDD patients versus 83% of non-SDD patients.
- The 30-day MACE incidence was 0% in the SDD group and 1.6% in the non-SDD group. Diabetes and longer procedural times were associated with lower SDD probability.
Conclusions:
- Same-day discharge (SDD) is a feasible and safe strategy for select patients undergoing uncomplicated CTO PCI via a forearm approach.
- This approach may contribute to reduced healthcare costs and improved patient experience.
Objectives:
To assess the feasibility and safety of same day discharge (SDD) after chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Background:
CTO PCI has been associated with higher complication rates and procedural and hospitalization costs. Shortening post-PCI hospitalization length not only increases the patients' comfort but at the same time it consists an important part of cost reduction policies.
Methods:
We retrospectively compared the 30-day outcomes of patients who underwent CTO PCI at the Red Cross Hospital, Greece between January 2016 and June 2019 and underwent SDD versus non-SDD. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction, urgent repeat target vessel revascularization, tamponade, and stroke.
Results:
A total of 173 patients (mean age 63.7 ± 8.9 years) were included, of whom 51 (30%) underwent SDD. SDD patients were less likely to have diabetes mellitus (51 vs. 31%, p = .015), arterial hypertension (89 vs. 67%, p < .001), and acute coronary syndrome presentation (39.7 vs. 21.6%, p = .022), compared with non-SDD patients. Forearm access was used in all SDD patients and in 83% of the non-SDD patients. The 30-day incidence of MACE was 0% in the SDD group and 1.6% in the non-SDD group. Multivariable analysis showed that diabetes mellitus and longer procedural time were associated with lower probability of SDD (OR: 0.34, 95% CI: 0.15, 0.73 and OR: 0.29, 95% CI: 0.12, 0.71, respectively).
Conclusions:
SDD appears to be feasible and safe in selected patients undergoing an uncomplicated CTO PCI through forearm approach.
