Assessing patient-reported outcomes and preferences for same-day discharge after percutaneous coronary intervention: Results from a pilot randomized, controlled trial

Michael Kim, Paul Muntner, Samin Sharma, James W. Choi, Robert C. Stoler, Mark Woodward, Devin M. Mann, Michael E. Farkouh

Research output: Contribution to journalArticlepeer-review

Abstract

Background-Same-day discharge after percutaneous coronary intervention (PCI) may be safe for some patients. Few data are available on patient-reported outcomes and preferences for same-day discharge after PCI. Methods and Results-Between March 2008 and March 2010, a total of 298 patients undergoing elective PCI via femoral access at 2 medical centers (Mount Sinai Hospital, New York, NY, and Baylor Medical Center, Dallas, TX) were randomized to same-day (n=150) or next-day (n=148) discharge. The primary outcome was high patient coping during the 7 days after discharge defined as scores <20 on the validated postdischarge coping difficulty scale. Safety outcomes, clopidogrel adherence, and patient preferences were secondary outcomes. Before discharge, patients randomized to same-day and next-day discharge were similar with respect to sociodemographic and clinical characteristics. High-coping ability, assessed 7 days after PCI, was present for 79% of patients randomized to same-day discharge and for 77% of patients randomized to next-day discharge. The difference in high coping ability, 2 (95% confidence interval, -7 to 11), did not cross the noninferiority threshold of -12% (P<0.001 that same-day discharge is not noninferior to next-day discharge). At 30 days after PCI, clopidogrel adherence, physician and emergency room visits, and hospitalization were similar in the 2 randomization groups. In addition, 80% and 68% of those randomized to same-day and next-day discharge, respectively, stated they would prefer same-day discharge if they were to have another PCI procedure. Conclusions-Same-day discharge after PCI was associated with patient-reported and clinical outcomes similar to those ofnext-day discharge and was preferred by most patients.

Original languageEnglish (US)
Pages (from-to)186-192
Number of pages7
JournalCirculation: Cardiovascular Quality and Outcomes
Volume6
Issue number2
DOIs
StatePublished - Mar 1 2013

Keywords

  • Hospital discharge
  • Patient satisfaction
  • Percutaneous coronary interventions
  • Randomized trial

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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