@article{650157701e974f9bb2fd13897ad00f77,
title = "Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention",
abstract = "Objectives: The aims of this study were 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. Background: Insights on contemporary use of same-day discharge following elective PCI are limited. Methods: 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. Results: A total of 114,461 patients (14.0%) were discharged the same day as 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 PCI and from 9.9% to 39.7% for radial-access PCI. Hospital-level variation in the use of same-day discharge persisted throughout (median odds ratio adjusted for year and radial access: 4.15). Risk-adjusted 30-day mortality did not change over time, while risk-adjusted rehospitalization decreased over time and more quickly for same-day discharge (P for interaction <0.001). Conclusions: In the past decade, a large increase in the use of same-day discharge following elective 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.",
keywords = "elective surgical procedures, length of stay, patient discharge, percutaneous coronary intervention, registries",
author = "Bradley, {Steven M.} and Kaltenbach, {Lisa A.} and Katelyn Xiang and Amin, {Amit P.} and Hess, {Paul L.} and Maddox, {Thomas M.} and Anil Poulose and Brilakis, {Emmanouil S.} and Paul Sorajja and Ho, {P. Michael} and Rao, {Sunil V.}",
note = "Funding Information: This study was supported by the American College of Cardiology{\textquoteright}s NCDR. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Representatives of the CathPCI Registry research and publications committee approved the final manuscript. Dr Bradley serves as an associate editor for JAMA Network Open. Dr Hess is supported by VA Career Development Award HX002621 from the U.S. Department of Veterans Affairs Health Services and Research Development Service and Career Development Award 19CDA347670126 from the American Heart Association. Dr Ho is supported by grants from the National Heart, Lung, and Blood Institute, the Department of Veterans Affairs Health Services and Research Development Service, and the University of Colorado School of Medicine; has a research agreement with Bristol Myers Squibb through the University of Colorado; and serves as the deputy editor for Circ Cardiovasc Qual Outcomes. Dr Maddox has received current grant funding from the National Center for Advancing Translational Sciences (grant 1U24TR002306-01: A National Center for Digital Health Informatics Innovation); is a consultant for Creative Educational Concepts and Atheneum Partners; has received honoraria and/or expense reimbursement in the past 3 years from New York Presbyterian (September 2017), Westchester Medical Center (October 2017), Sentara Heart Hospital (December 2018), the Henry Ford health system (March 2019), and the University of California-San Diego (January 2020); is currently employed as a cardiologist and the executive director of the Healthcare Innovation Lab at BJC HealthCare/Washington University School of Medicine, in which capacity he is an adviser to Myia Labs, for which his employer receives equity compensation in the company, but he receives no individual compensation from the company; and is a compensated director for a New Mexico–based foundation, the J.F. Maddox Foundation. Dr Brilakis has received consulting and speaker honoraria from Abbott Vascular, the American Heart Association (associate editor, Circulation), Amgen, Biotronik, Boston Scientific, the Cardiovascular Innovations Foundation (board of directors), CSI, Elsevier, GE Healthcare, InfraRedx, Medtronic, Siemens, and Teleflex; has received research support from Regeneron and Siemens; and is a shareholder in MHI Ventures. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2021 American College of Cardiology Foundation",
year = "2021",
month = aug,
day = "9",
doi = "10.1016/j.jcin.2021.05.043",
language = "English (US)",
volume = "14",
pages = "1655--1666",
journal = "JACC: Cardiovascular Interventions",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "15",
}