Making Elective PCI an Outpatient Procedure to Save Costs Could Put Some Patients at Risk; New Document Guides Physicians in Making Length-of-Stay Decisions
LAS VEGAS, May 7 /PRNewswire/ -- Changes in reimbursement have put pressure on health care facilities to shift more elective percutaneous coronary interventions (PCIs) to "same-day" outpatient procedures. This marked shift could place patients at risk if they are sent home prematurely, and has left physicians without clear guidance as to when such early discharge is appropriate. To help guide physicians in making these decisions, the Society for Cardiovascular Angiography and Interventions (SCAI) has published an expert consensus statement outlining the variables physicians should consider when deciding how long patients should stay in the hospital following an uncomplicated elective PCI. The document, titled "Defining the Length of Stay Following Percutaneous Coronary Intervention," was published online today in Catheterization and Cardiovascular Interventions (CCI; e-publication ahead of print, June 2009, vol. 73, issue 7) and has been endorsed by the American College of Cardiology Foundation.
Elective PCI refers to patients who have stable symptoms but abnormalities in testing that indicate the need for further evaluation by coronary angiography. Depending on the results of the angiogram, some will go on to have a PCI procedure. While short length of stay following an uncomplicated PCI is a key benefit of the procedure, the current standard in the United States is for the patient to remain overnight in a health care facility.
"Because of continued breakthroughs in interventional cardiology, few patients today have to stay in the hospital for two or more days after angioplasty as they did in the past, but it's not always clear which patients should be kept overnight or admitted to the hospital, and which patients can safely return home the same day," said Carl Tommaso, MD, FSCAI, associate professor of medicine at
According to the consensus paper, some patients may safely go home the same day as their PCI, but other patients should be placed in one of three settings determined by the treating physician:
The consensus paper provides a decision matrix to guide physicians in determining the appropriate length of stay following PCI.
"Each patient situation is unique and we have to consider all the variables when determining follow-up care, including whether a patient has someone at home to help him or her," said Gregory J. Dehmer, MD, FSCAI, professor of medicine at
"Interventional cardiologists support optimal care for each patient balanced against responsible measures to reduce unnecessary medical costs. This paper from SCAI is designed to provide guidance to help physicians make the most appropriate decisions on follow-up care after PCI," said SCAI President-Elect Steven R. Bailey, MD, FSCAI, chair of the Division of Cardiology, professor of medicine and radiology, and Janey Briscoe Distinguished Chair at the
Headquartered in Washington, D.C., the Society for Cardiovascular Angiography and Interventions is a 4,000-member professional organization representing invasive and interventional cardiologists in more than 60 nations. SCAI's mission is to promote excellence in invasive and interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. SCAI's annual meeting has become the leading venue for education, discussion, and debate about the latest developments in this dynamic medical specialty. SCAI's patient and physician education program, Seconds Count, offers comprehensive information about cardiovascular disease. For more information about SCAI and Seconds Count, visit www.scai.org or www.seconds-count.org.
|SOURCE Society for Cardiovascular Angiography and Interventions|
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