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Predictors for Nonhome Patient Discharge following Lower Extremity Arterial Interventions
Sienna Li1, Diego B López González2, John Di Capua2
1Harvard Medical School, Harvard University, Boston, Massachusetts.
Summary
Older age, longer operative time, preprocedural wounds, renal failure, congestive heart failure, and severe symptoms predict nonhome discharge after lower extremity arterial interventions for peripheral artery disease (PAD). Early discharge planning is crucial.
Area of Science:
- Vascular Surgery
- Health Services Research
- Patient Outcomes
Background:
- Peripheral artery disease (PAD) affects lower extremities, necessitating arterial interventions.
- Optimizing postprocedural care and discharge planning is essential for patients undergoing these procedures.
Purpose of the Study:
- To identify variables associated with nonhome discharge following lower extremity arterial interventions for PAD.
- To inform strategies for improving postprocedural care and discharge planning.
Main Methods:
- Utilized the 2014-2017 American College of Surgeons National Surgical Quality Improvement Program database.
- Analyzed endovascular infrainguinal interventions for PAD, focusing on nonhome discharge as the primary outcome.
- Employed univariate analysis and multivariate logistic regression to identify associated covariates.
Main Results:
- 20.8% of 3,190 patients had nonhome discharge.
- Key predictors for nonhome discharge included older age (≥77 years), prolonged operative time, preprocedural wounds, renal failure, congestive heart failure (CHF), and symptom severity.
- Independent functional status was associated with a lower likelihood of nonhome discharge.
Conclusions:
- Factors such as prolonged procedural time, preprocedural wounds, comorbidities, symptomatology, and functional status can identify patients needing nonhome discharge.
- These findings support early discharge planning for at-risk individuals undergoing lower extremity arterial interventions.
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