FACTORS LIMITING SAME-DAY DISCHARGE AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN LOW-RISK PATIENTS

Authors

  • Bashir Ahmed Solangi National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Jehangir Ali Shah National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Kamran Ahmed Khan National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Rajesh Kumar National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Gulzar Ali National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Muhammad Hassan National Institute of Cardiovascular Diseases (NICVD), Sukkur, Pakistan
  • Mehwish Zehra Jinnah Post Graduate Medical Center (JPMC), Karachi, Pakistan
  • Usman Bhatti National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Jawaid Akbar Sial National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Tahir Saghir National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v55i2.2213

Abstract

Objectives: The objective of this study was to assess the factors associated with delay in discharge of low risk patients after primary percutaneous coronary intervention (PCI) at a tertiary care cardiac center.

Methodology: In this study we included consecutive patients undergone primary PCI categorized as low risk based on the Zwolle risk score (ZRS) with the score of ≤3. Patients were stratified into two groups same-day discharge (SDD) and late discharge (>24 hours).

Results: A total of 491 patients were include out of which 82.7% (406) were male and mean age of the study sample was 53.37±10.65 years. Of the total 87.6% (430) patients were discharged on the same-day by the treating physician. Delay in discharge was found to be associated with female gender (26.2% (16/61) vs. 16% (69/430); p=0.049), inferior wall myocardial infarction (59% (36/61) vs. 45.3% (195/430); p=0.045), femoral access for the procedure (67.2% (41/61) vs. 49.8% (430); p=0.011), culprit right coronary artery (47.5% (29/61) vs. 31.2% (134/430); p=0.011), and post-procedure complications (4.9% (3/61) vs. 0.5% (2/430); p=0.015).

Conclusion: A significant number of low risk patients did not get to discharge within same day of the procedure. Delay in discharge of low risk patients after primary PCI was observed to be associated with some of the patients and procedure related factors such as female gender, inferior wall myocardial infarction, femoral access for the procedure, culprit right coronary artery, and post-procedure complications.

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Published

2022-07-05

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Original Article