A team of researchers conducted a study to describe trends and hospital variation in same-day discharge following elective percutaneous coronary intervention (PCI) and to evaluate the association between trends in same-day discharge and patient outcomes.
In a sequential cross-sectional analysis of 819,091 patients undergoing elective PCI at 1,716 hospitals in the National Cardiovascular Data Registry CathPCI Registry from July 1, 2009, to December 31, 2017, overall and hospital-level trends in same-day discharge were assessed. Among the 212,369 patients who linked to Centers for Medicare and Medicaid Services data, the association between same-day discharge and 30-day mortality and rehospitalization was assessed.
The results of the study are as follows:
- A total of 114,461 patients (14.0%) were discharged the same day as Percutaneous Coronary Intervention (PCI).
- The proportion of patients with same-day discharge increased from 4.5% in the third quarter of 2009 to 28.6% in the fourth quarter of 2017.
- From 2009 to 2017, the rate of same-day discharge increased from 4.3% to 19.5% for femoral-access Percutaneous Coronary Intervention (PCI) and from 9.9% to 39.7% for radial-access Percutaneous Coronary Intervention (PCI). Hospital-level variation in the use of same-day discharge persisted throughout.
- Risk-adjusted 30-day mortality did not change over time, while risk-adjusted rehospitalization decreased over time and more quickly for same-day discharge.
Thus, the researchers concluded that in the past decade, a large increase in the use of same-day discharge following elective Percutaneous Coronary Intervention (PCI) was not associated with worse 30-day mortality or rehospitalization. Hospital-level variation in same-day discharge may represent an opportunity to reduce costs without compromising patient outcomes.
Reference:
Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention by published in the JACC: Cardiovascular Interventions https://www.jacc.org/doi/10.1016/j.jcin.2021.05.043
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