Clinical Outcomes of Early Versus Delayed Discharge After Primary Percutaneous Coronary Intervention

Abstract

BACKGROUND: Heart disease is the most significant cause of death worldwide and ST- elevation myocardial infarction (STEMI) is a prime cause of death in developing nations. PCI has progressed to the point where overnight monitoring is unnecessary for some patients because of its increased safety and effectiveness. Improved patient satisfaction, shorter hospital stays, and more efficient use of healthcare resources are the key advantages of same-day release following PCI. PCI has always been viewed as an inpatient or short-stay surgery, requiring up to 24 hours of observation time. The purpose of this research was to make comparison of the outcomes of early and delayed discharge strategy after primary PCI in patients with STEMI and to establish the frequency of early discharge following primary PCI in patients having STEMI.
 METHODOLOGY: The study was conducted in Cardiology department of Punjab Institute of Cardiology, Lahore from August 10, 2020 to February 10, 2021. Total 200 patients presenting with STEMI were enrolled in the study. Patients underwent primary PCI by a single team with assistance of researcher. If patients were discharged within 36 hours, then earlier discharge was labeled. Patients were asked to present after 1 month in OPD. Patients were advised to present in case they feel similar symptoms of myocardial infarction, stroke, heart failure or mortality. The collected data were analysed statistically by using SPSS v25.0. Both groups were compared using chi-square test for clinical outcome. Data were stratified for age, gender, h/o diabetes, hypertension, smoking and duration of symptoms. Post-stratification, both groups were compared by using chi-square test for clinical outcome in each strata. A p-value ?0.05 was taken as significant.
 RESULTS: Total 200 patients presenting with STEMI and underwent primary PCI were enrolled in this study. There were 146(73.0%) were males and 54(27.0%) were females. The mean age of patients was 50.6±19.2 years. Out of 200 patients with STEMI, 86(43.0%) were early discharged and 114(57.0%) had delayed discharged.
 CONCLUSION: This study showed that early discharge is also safe and feasible among patients with STEMI who underwent PCI as compared to delayed discharge. Early discharge may help in lowering down healthcare costs for Primary PCI service providers