From the Guidelines
Yes, a patient can be discharged home on the same day as a Cardiac Catheterization (Cath) procedure, as long as they meet the criteria outlined in the Pre-Discharge Checklist, which includes confirmation of loading dose of P2Y12 inhibitors, prescriptions for at least 30 days of P2Y12 inhibitors, aspirin, and statin, and education on monitoring the access site and taking dual antiplatelet therapy as prescribed 1.
Key Considerations for Same-Day Discharge
- The patient must have a stable medical condition and be at low risk for complications from the procedure 1.
- The patient must have adequate social support, including a caregiver to monitor them for the next 24 hours, and a stable residence to return to 1.
- The patient must be willing to be discharged the same day and understand the possibility of same-day discharge 1.
- The healthcare team must complete the Pre-Discharge Checklist, which includes administration of P2Y12 inhibitors, prescriptions for P2Y12 inhibitors, aspirin, and statin, and education on monitoring the access site and taking dual antiplatelet therapy as prescribed 1.
Benefits of Same-Day Discharge
- Same-day discharge benefits both patients and facilities by increasing patient satisfaction, reducing costs, and increasing bed capacity 1.
- Same-day discharge can be safely performed in patients who meet the criteria outlined in the Pre-Discharge Checklist, with no increase in death or rehospitalization compared to patients who stay for overnight monitoring 1.
Important Factors to Consider
- Clinical factors, such as complications during or after the procedure, and social factors, such as adequate social support and a stable residence, must be carefully evaluated before making a decision about same-day discharge 1.
- The healthcare team must provide clear instructions and education to the patient and caregiver on activity restrictions, wound care, and medication management before discharge 1.
From the Research
Discharge After Cardiac Catheterization
- The decision to discharge a patient on the same day as a Cardiac Catheterization (Cath) procedure depends on various factors, including the patient's overall health and the complexity of the procedure 2, 3.
- Studies have shown that same-day discharge after outpatient percutaneous coronary intervention (PCI) is safe and feasible, with low rates of major adverse cardiac events and readmissions 3, 4.
- A study published in 2020 found that same-day discharge after PCI was not associated with increased adverse events, and that drive time and distance traveled did not impact outcomes 3.
- Another study published in 2016 found that same-day discharge after coronary stenting and femoral artery device closure was associated with similar clinical outcomes, patient satisfaction, and cost savings compared to overnight hospital stay 4.
- However, it is essential to note that not all patients may be suitable for same-day discharge, and individual assessment is necessary to determine the best course of action 2, 5.
- Factors such as vascular complications, recurrent chest pain, and the need for hemodynamic support may require extended hospital stay or repeat procedures 6.
- Effective discharge planning, including early assessment, coordination of care, and communication with the patient and their family or carers, is crucial to ensure safe and successful discharge 5.