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Outpatient cardiac catheterisation

J S Skinner1, P C Adams

  • 1Department of Cardiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

International Journal of Cardiology
|March 1, 1996
PubMed
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Outpatient cardiac catheterisation offers financial savings and increased bed availability. While patient satisfaction is high, minor complications can occur, necessitating careful patient selection and adherence to guidelines for safe outpatient procedures.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Health Services Research

Background:

  • Cardiac catheterisation is increasingly performed in outpatient settings, offering potential financial benefits and improved hospital resource utilization.
  • While often performed with immediate surgical access, some units are more distant, raising questions about safety and patient selection.
  • Existing data show variability in complication rates and patient eligibility across different studies and healthcare systems.

Purpose of the Study:

  • To evaluate the safety, efficacy, and patient satisfaction of outpatient cardiac catheterisation compared to inpatient procedures.
  • To review the current literature on complication rates, patient selection criteria, and unplanned admission rates in outpatient cardiac catheterisation.
  • To assess the applicability of existing guidelines, such as those from the American College of Cardiology/American Heart Association (ACC/AHA), in different clinical settings.

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Main Methods:

  • Systematic review and analysis of existing studies on outpatient cardiac catheterisation.
  • Comparison of complication rates (major and minor) and unplanned admission rates between inpatient and outpatient settings.
  • Evaluation of patient satisfaction and the proportion of patients eligible for outpatient procedures based on varying exclusion criteria.

Main Results:

  • Outpatient cardiac catheterisation leads to significant cost savings (11-54%) and increased bed availability.
  • Patient satisfaction is generally high, comparable to inpatients, though some may have unanswered questions.
  • A randomized trial showed minor bleeding/hematoma in 3.6% of outpatients; major complication rates are infrequent but require large studies to detect differences. Unplanned admission rates vary widely ( <1% to 19%).

Conclusions:

  • Outpatient cardiac catheterisation is a safe and cost-effective alternative for selected patients, particularly when following established guidelines.
  • The American College of Cardiology/American Heart Association (ACC/AHA) guidelines aid in identifying low-risk patients, demonstrated by low complication rates in mobile units.
  • Further research and standardized guidelines are needed to optimize patient selection and minimize risks across diverse healthcare settings, considering variations between countries like the USA and UK.