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

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.