Department of Cardiology, Hippokration General Hospital, 114 VasilisisSofias str, Athens, Greece.
First Cardiology Division, Medical School, Hippokration General Hospital, University of Athens, 114 VasilisisSofias str, Athens, Greece.
J Interv Card Electrophysiol. 2023 Mar;66(2):471-481. doi: 10.1007/s10840-022-01319-5. Epub 2022 Sep 5.
The strategy of cardiac implantable electronic device (CIED) implantations performed as day-case admissions has gained a wider acceptance overtime; however, data on safety are still limited. This study aims to investigate the safety of a same-day discharge protocol introduced in our hospital for the postprocedural management of patients undergoing CIED implantation.
Α prospective, non-interventional, non-randomised study performed in a single high-volume implanting centre for a 16-month period (March 2020 to June 2021). At total of 821 of 965 (85.1%) patients scheduled for elective CIED implantation were considered to be eligible for inclusion in the Short-stay Device Management Protocol. These patients were compared with a historical group of 932 patients, meeting the same inclusion criteria.
Procedure was successful in 812 patients (98.9%), committed to same-day discharge versus 921 of 932 patients (98.8%) admitted for overnight stay (p = 0.87). Overall, 90-day complication rate was comparable in both groups (4.14% vs 4.07%, p = 0.95), as was major (1.46% vs. 1.82%, p = 0.55) and minor (2.67% vs. 2.25%, p = 0.64) complication rates. The composite early post-procedural complication rates and late post-procedural complication rates were comparable among groups (0.97 vs 1.18%, p = 0.70 and 0.73% vs 0.64%, p = 0.83, respectively). Six hundred sixty-seven patients (84%) preferred the same-day discharge strategy. Finally, a reduction of 792 bed-days was recorded, resulting in possible financial Health System benefits.
Same-day discharge is feasible and safe in the majority of patients referred for CIED implantation. Additionally, same-day discharge is preferred by patients and may reduce procedure-related costs due to significant bed-day reductions.
心脏植入式电子设备（CIED）植入作为日间住院治疗的策略已经得到了更广泛的认可；然而，关于安全性的数据仍然有限。本研究旨在调查我们医院引入的用于 CIED 植入术后患者管理的当日出院方案的安全性。
这是一项前瞻性、非干预性、非随机研究，在一个高容量植入中心进行了 16 个月（2020 年 3 月至 2021 年 6 月）。共有 821 名符合条件的患者（965 名患者中的 85.1%）被认为适合纳入短期设备管理方案。这些患者与符合相同纳入标准的 932 名历史组患者进行了比较。
812 名患者（98.9%）的手术成功，他们被安排当日出院，而 932 名患者中的 921 名（98.8%）患者则被安排过夜住院（p=0.87）。在两组中，90 天并发症发生率相似（4.14%对 4.07%，p=0.95），主要并发症（1.46%对 1.82%，p=0.55）和小并发症（2.67%对 2.25%，p=0.64）发生率也相似。两组间的复合早期术后并发症发生率和晚期术后并发症发生率相似（0.97%对 1.18%，p=0.70 和 0.73%对 0.64%，p=0.83）。667 名患者（84%）更喜欢当日出院策略。最后，记录了 792 个床位日的减少，这可能为卫生系统带来了经济利益。
在大多数接受 CIED 植入的患者中，当日出院是可行和安全的。此外，由于显著减少了床位日，当日出院也受到患者的青睐，并可能降低与手术相关的成本。
