Small Study Evaluates Same‐Day Discharge After Peripheral Artery Interventions

 

April 12, 2018—In Catheterization and Cardiovascular Interventions, Ashequl M. Islam, MD, et al published findings from a randomized controlled study to assess the feasibility, safety, and patient satisfaction of same‐day discharge after peripheral artery interventions.

The background of the study is that although diagnostic angiography is routinely performed as a same‐day procedure, same‐day percutaneous transluminal angioplasty is less common. Because there is a very low incidence of periprocedural complications after 4 hours, discharge after this window is possible provided the patient is able to ambulate and has necessary social support. Safety and patient satisfaction related to same‐day discharge have not been systematically studied in this population, noted the investigators.

As summarized in Catheterization and Cardiovascular Interventions, patients undergoing outpatient peripheral artery interventions at a single institution between 2011 and 2015 were randomized to usual care (overnight stay) or same-day discharge after successful interventions. Patient satisfaction, complications, and readmission status were ascertained by blinded telephone interviewers between 48 and 72 hours and 10 days postprocedure.

A total of 24 patients consented to participating in the study. Of these patients, five (21.7%) failed screening, leaving 19 patients for randomization to control (n = 10) and experimental group (n = 9) conditions. The same-day discharge group experienced zero complications; however, their Likert scale scores were significantly lower than overnight stay for the perceived level of safety (P = .02) and the likelihood of having the procedure again (P = .004).

This small, single‐center randomized study found that among carefully selected peripheral artery interventions, same-day discharge may be feasible and safe. However, patient satisfaction and perceived safety were significantly lower among those in the same-day discharge group compared with the overnight stay group. Larger prospective studies are warranted to confirm these findings, advised the investigators in Catheterization and Cardiovascular Interventions.

 

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