Koutouzis Michail, Agelaki Maria, Maniotis Christos, Dimitriou Panagiotis, Tsoulmeleas Andreas, Matsoukis Ioannis, Andreou Constantinos, Lazaris Efstathios
Second Cardiology Department, Hellenic Red Cross Hospital, Athens, Greece.
Second Cardiology Department, Hellenic Red Cross Hospital, Athens, Greece.
Cardiovasc Revasc Med. 2017 Jun;18(4):241-244. doi: 10.1016/j.carrev.2017.01.003. Epub 2017 Jan 8.
The aim of this study is to identify possible predictors for same day discharge (SDD) after percutaneous coronary interventions (PCI).
Same day discharge after PCI is becoming more and more appealing and patient's selection criteria are being formulated.
A retrospective analysis was performed in all PCI procedures from January 2013 until December 2015. Patients were discharged the same day (SDD group) or had at least one overnight stay (non-SDD group). The decision of SDD or not was on treating physician discretion. We evaluated predictors of SDD decision by a logistic regression analysis.
One thousand one hundred sixty eight procedures were performed from our department during the study period: 308 patients (26.4%) were discharged the same day (SDD group) and the rest 860 procedures (73.6%) had at least one overnight stay (non-SDD group). Multivariate analysis revealed that forearm approach (OR=5.498, CI: 2.067-14.629; p=<0.001), patient's residency proximal to the hospital (OR=4.543, CI: 2.406-8.580; p<0.001), completion of the procedure before 13,00p.m. (OR=3.437, CI: 1.789-0.6.601; p<0.001) and the success of the performed procedure (OR=1.125, CI 1.043-2.135; p=0.044) were positive predictors of SDD, while presentation with non-ST elevation myocardial infarction or unstable angina (OR=0.542, CI: 0.268-0.872; p<0.010) and amount of contrast used (OR=0.910, CI: 0.852-0.969; p<0.030) were negative predictors of SDD.
In retrospect, both procedural and demographic details play a crucial role in patient selection for same day discharge post coronary percutaneous intervention.
本研究旨在确定经皮冠状动脉介入治疗（PCI）后当日出院（SDD）的可能预测因素。
PCI术后当日出院越来越具有吸引力，患者选择标准也在制定中。
对2013年1月至2015年12月期间所有PCI手术进行回顾性分析。患者于当日出院（SDD组）或至少住院一晚（非SDD组）。SDD与否由治疗医生决定。我们通过逻辑回归分析评估SDD决策的预测因素。
研究期间，我科共进行了1168例手术：308例患者（26.4%）当日出院（SDD组），其余860例手术（73.6%）至少住院一晚（非SDD组）。多因素分析显示，前臂入路（OR=5.498，CI：2.067 - 14.629；p<0.001）、患者居住在医院附近（OR=4.543，CI：2.406 - 8.580；p<0.001）、手术于下午1点前完成（OR=3.437，CI：1.789 - 6.601；p<0.001）以及手术成功（OR=1.125，CI 1.043 - 2.135；p=0.044）是SDD的阳性预测因素，而非ST段抬高型心肌梗死或不稳定型心绞痛（OR=0.542，CI：0.268 - 0.872；p<0.010）以及造影剂用量（OR=0.910，CI：0.852 - 0.969；p<0.030）是SDD的阴性预测因素。
回顾性分析表明，手术细节和人口统计学细节在冠状动脉介入治疗后当日出院患者的选择中都起着关键作用。
