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Unplanned admissions after outpatient cardiac catheterization
Insights
Fifteen percent of patients admitted after outpatient cardiac catheterization needed urgent intervention or experienced complications. Older patients and women were more likely to be admitted, highlighting the need for careful patient selection.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Services Research
Background:
- Outpatient cardiac catheterization is increasingly common.
- A small but significant percentage of patients require unplanned hospital admission post-procedure.
Purpose of the Study:
- To determine the incidence and reasons for unplanned hospital admissions after outpatient cardiac catheterization.
- To identify patient characteristics associated with increased admission risk.
Main Methods:
- Prospective review of consecutive outpatient cardiac catheterizations over one year.
- Analysis of 847 patients, categorizing admitted patients into four groups based on admission reason.
Main Results:
- 15% (130/847) of patients required hospital admission.
- Primary reasons included immediate percutaneous transluminal coronary angioplasty (33%), urgent intervention for severe cardiac disease (48%), complications/hemodynamic instability (15%), and late procedure completion (4%).
- Patients over 65 and women (especially with complications) had higher admission rates.
Conclusions:
- Outpatient cardiac catheterization has a 15% unplanned admission rate.
- Urgent interventions and complications are key drivers of admission.
- Patient age and sex influence admission risk and reasons, informing patient selection and post-procedure care strategies.
Abstract:
Increasing numbers of patients are undergoing diagnostic catheterization as outpatients; however, a small proportion of patients requires hospital admission following the procedure. Unplanned admissions after consecutive outpatient cardiac catheterizations performed during 1 year were prospectively reviewed to determine the incidence of and reasons for admission. Among 847 patients undergoing outpatient cardiac catheterization, 130 patients (15%) required hospital admission after the procedure. Admitted patients were divided into four groups: patients undergoing immediate percutaneous transluminal coronary angioplasty (PTCA) (Group 1; 33%), patients with severe cardiac disease requiring urgent intervention (Group 2; 48%), patients suffering complications or hemodynamic instability (Group 3; 15%), and patients whose procedures were completed too late to allow same-day discharge (Group 4; 4%). Patients over 65 were more likely to require admission and women were more likely to be admitted with complications or hemodynamic instability. Findings are compared with results of other outpatient series, and implications regarding appropriate setting for outpatient catheterization are discussed.