The safety of same-day discharge following percutaneous coronary intervention in regional Australia

Abstract

Background: Same-day discharge (SDD) following percutaneous coronary intervention (PCI) has proven safe, and global adoption of this strategy has been increasing rapidly. These data are predominantly derived from high-volume, metropolitan centres with a relative paucity of data from regional and remote settings.

Aims: The primary objective of this study was to evaluate the outcomes of a same-day, criteria-led discharge strategy following elective transradial PCI in a regional setting.

Methods: This is a retrospective, single-centre cohort study. Consecutive outpatients aged ≥18 years presenting for elective transradial invasive coronary angiography between March 2019 and February 2024 were included in the analysis. We report the primary composite outcome of 30-day all-cause mortality and unplanned hospital readmission and compare proportions between those who were discharged on the day of their procedure with those admitted overnight in hospital and discharged the next day.

Results: A total of 555 eligible patients were identified, of which 330 (60%) were discharged on the day of their procedure. The composite primary end-point occurred in seven (2%) of the SDD patients and in six (3%) of the overnight admission patients (relative risk = 0.80; 95% confidence interval = 0.27-2.34; P = 0.68). No significant differences were seen in rates of readmission, or in other clinical outcomes assessed, including death, myocardial infarction, stroke and vascular complications or bleeding.

Conclusion: In a regional setting, SDD following elective transradial PCI, in select patients, is a safe approach which was not associated with higher rates of unplanned readmission or adverse clinical outcomes.