Department of Medicine, Long Beach Veterans Affairs Healthcare System, Long Beach, California.
Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
Catheter Cardiovasc Interv. 2018 Oct 1;92(4):717-731. doi: 10.1002/ccd.27637. Epub 2018 Apr 24.
Since the publication of the 2009 SCAI Expert Consensus Document on Length of Stay Following percutaneous coronary intervention (PCI), advances in vascular access techniques, stent technology, and antiplatelet pharmacology have facilitated changes in discharge patterns following PCI. Additional clinical studies have demonstrated the safety of early and same day discharge in selected patients with uncomplicated PCI, while reimbursement policies have discouraged unnecessary hospitalization. This consensus update: (1) clarifies clinical and reimbursement definitions of discharge strategies, (2) reviews the technological advances and literature supporting reduced hospitalization duration and risk assessment, and (3) describes changes to the consensus recommendations on length of stay following PCI (Supporting Information Table S1). These recommendations are intended to support reasonable clinical decision making regarding postprocedure length of stay for a broad spectrum of patients undergoing PCI, rather than prescribing a specific period of observation for individual patients.
自 2009 年美国心血管造影与介入学会(SCAI)专家共识文件发布以来,经皮冠状动脉介入治疗(PCI)后住院时间的延长,血管入路技术、支架技术和抗血小板药理学的进步,已经改变了 PCI 后的出院模式。其他临床研究已经证明了在特定的、无并发症的 PCI 患者中,早期和当天出院的安全性,而报销政策也阻止了不必要的住院。本共识更新版:(1)阐明了出院策略的临床和报销定义,(2)回顾了支持缩短住院时间和风险评估的技术进步和文献,(3)描述了 PCI 后住院时间的共识建议的变化(支持信息表 S1)。这些建议旨在支持对接受 PCI 的广泛患者的术后住院时间进行合理的临床决策,而不是为个别患者规定特定的观察期。