AI Article Synopsis
- The study aimed to compare the effects and costs of early discharge versus ordinary discharge after percutaneous coronary intervention (PCI), focusing on risks such as re-infarction, stroke, death, and rehospitalization.
- It was a systematic review and meta-analysis of 12 trials involving nearly 3,000 patients, showing that early discharge had a relative risk reduction of 35% for major complications, but an increased risk of rehospitalization in most patient groups, especially with hypertension.
- Early discharge also resulted in a cost saving of 655 Euros per patient, and the findings suggest that early discharge is generally safe for diverse coronary artery disease patients, though more research is needed for those with acute coronary syndrome.*
Article Abstract
Aim: We aimed to summarize the pooled effect of early discharge compared with ordinary discharge after percutaneous coronary intervention (PCI) on the composite endpoint of re-infarction, revascularization, stroke, death, and incidence of rehospitalization. We also aimed to compare costs for the two strategies.
Methods: The study was a systematic review and a meta-analysis of 12 randomized controlled trials including 2962 patients, followed by trial sequential analysis. An estimation of cost was considered. Follow-up time was 30 days.
Results: For early discharge, pooled effect for the composite endpoint was relative risk of efficacy (RRe)=0.65, 95% confidence interval (CI) (0.52-0.81). Rehospitalization had a pooled effect of RRe=1.10, 95% CI (0.88-1.38). Early discharge had an increasing risk of rehospitalization with increasing frequency of hypertension for all populations, except those with stable angina, where a decreasing risk was noted. Advancing age gave increased risk of revascularization. Early discharge had a cost reduction of 655 Euros per patient compared with ordinary discharge.
Conclusion: The pooled effect supports the safe use of early discharge after PCI in the treatment of a heterogeneous population of patients with coronary artery disease. There was an increased risk of rehospitalization for all subpopulations, except patients with stable angina. Clinical trials with homogeneous populations of acute coronary syndrome are needed to be conclusive on this issue.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367460 | PMC |
| http://dx.doi.org/10.2147/VHRM.S122951 | DOI Listing |
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