Variation in practice and concordance with guideline criteria for length of stay after elective percutaneous coronary intervention

• Published in: Catheterization and cardiovascular interventions Vol. 90; no. 5; pp. 715 - 722
• Main Authors: Din, Jehangir N., Snow, Thomas M., Rao, Sunil V., Klinke, W. Peter, Nadra, Imad J., Della Siega, Anthony, Robinson, Simon D.
• Format: Journal Article
• Language: English
• Published: United States 01.11.2017
• Subjects: Aged; Aged, 80 and over; CAD—coronary artery disease; Canada; Consensus; Europe; Female; Guideline Adherence - trends; HCP—health care policy; Health Care Surveys; Health Knowledge, Attitudes, Practice; Healthcare Disparities - trends; Humans; Length of Stay - trends; Male; PCI—percutaneous coronary intervention (PCI); Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - trends; Practice Guidelines as Topic; Practice Patterns, Physicians' - trends; Process Assessment (Health Care) - trends; Risk Factors; Time Factors; Treatment Outcome; United States; CAD-coronary artery disease; PCI-percutaneous coronary intervention (PCI); HCP-health care policy
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.26992

Background Considerable variability remains as regards the appropriate and safe length of stay after elective PCI. We performed a survey of interventional cardiologists to identify current views on appropriate and safe length of stay after PCI. Methods We created an online survey using the commercially available SurveyMonkey application. This was sent to interventional cardiologists in the US, Canada and the UK with the assistance of the national interventional cardiology societies (SCAI, CAIC/CCS, BCIS/BCS) as well as being made available on the theheart.org website. Results 505 interventional cardiologists responded, of which 237 were practicing in the US. Of those from the US, 52% were not aware of any guidelines for length of stay and 48% reported that their unit did not have a standard practice for length of stay. Same‐day discharge after PCI was practiced as routine by 14% of cardiologists in the US versus 32% of cardiologists from Canada (P = 0.003) and 57% (P < 0.0001) from the UK. Amongst respondents, there was significant variation between respondents and divergence from published SCAI guidelines regarding appropriate length of stay for patient specific and procedural related clinical factors. Conclusions There is considerable variation in practice patterns regarding length of stay after PCI. Whilst most cardiologists practice overnight observation, a significant minority utilize same‐day discharge. There is also lack of familiarity with published guidelines. This variation and knowledge gap confirms an urgent need for updated guidelines and a concerted effort to educate cardiologists on appropriate post‐PCI length of stay. © 2017 Wiley Periodicals, Inc.