Cost-Effectiveness and Safety of Same-Day Discharge after Elective Percutaneous Coronary Intervention

• Published in: Hearts (Basel, Switzerland) Vol. 2; no. 4; pp. 561 - 569
• Main Authors: Prashar, Abhisheik, Mitchell, Kurt, Hopkins, Andrew, Sader, Mark, Prasan, Ananth M.
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 08-12-2021
• Subjects: Acute coronary syndromes; Angioplasty; Blood platelets; Cardiovascular disease; Clinical outcomes; coronary angiography; Cost estimates; Heart attacks; Hospital costs; Hospitalization; Intervention; Ischemia; length of stay; Medical imaging; Patient satisfaction; percutaneous coronary intervention; same-day discharge; Software; Stents; Veins & arteries; Sydney New South Wales Australia; Australia
• ISSN: 2673-3846; 2673-3846
• DOI: 10.3390/hearts2040043

Objectives: We sought to investigate the rates of same-day discharge (SDD) post elective percutaneous coronary intervention (PCI) at our institution and review its safety by examining clinical outcomes. We also performed an economic analysis evaluating our hospital’s cost data for SDD following PCI. Methods: Patients undergoing elective PCI at St George Hospital, Australia, from January 2017 to December 2019 were evaluated. Primary outcomes included 7-day major adverse cardiovascular endpoints (MACEs) and readmission to hospital within 30 days. Results: Among 502 patients who underwent elective PCI, 421 patients (83.8%) were managed with SDD. There was one case of acute stent thrombosis and one case of coronary wire-induced perforation requiring a pericardial drain that occurred following elective PCI with SDD (0.54%). Unplanned cardiac re-hospitalisation at 30 days following elective PCI was 5.2%. SDD after elective PCI was associated with a healthcare cost saving of AUD 4817 per case. Conclusion: SDD following elective PCI was demonstrated to be a safe and effective strategy that was also associated with significant cost savings. SDD following elective PCI warrants more widespread use as it lowers healthcare costs, has equivalent patient outcomes and improves patient satisfaction.