scholarly journals Safety and cost analysis of early discharge following percutaneous coronary intervention for acute coronary syndrome in patients with diabetes mellitus

2019 ◽  
Vol 47 (8) ◽  
pp. 3905-3917
Author(s):  
Shihong Li ◽  
Zhizhong Li ◽  
Xuejian Hou ◽  
Junping Sun ◽  
Lihui Kang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Intervention ◽  
Early Discharge ◽  
Mortality And Morbidity ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Hospitalization Costs ◽  
Patients With Diabetes

Objective To evaluate the safety and cost of early discharge compared with ordinary discharge in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI) for acute coronary syndrome. Methods We performed a retrospective analysis of prospectively collected data from 474 patients with DM who were discharged from hospital following PCI at a regional center between 2012 and 2015. Results A total of 192 patients (40.5%) were included in the early discharge group and 282 patients (59.5%) were included in the ordinary group. Mortality and morbidity after PCI were recorded. Kaplan–Meier analysis showed similar prognosis between the two groups at 30 days and at 1 year after discharge. However, hospitalization expenses for the regular discharge group were significantly higher than those of the early discharge group (RMB65,750 vs. RMB50,983). Conclusion Our findings demonstrate that early discharge of patients with DM following PCI for acute coronary syndrome is safe compared with ordinary discharge, and may reduce hospitalization costs.

Assessment Framework for Recognizing Clinical Deterioration in Patients With ACS Undergoing PCI

2021 ◽  
Vol 41 (4) ◽  
pp. 18-28
Author(s):  
Kevin White ◽  
Judy Currey ◽  
Julie Considine
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Signs And Symptoms ◽  
Coronary Artery Occlusion ◽  
Coronary Intervention ◽  
Clinical Deterioration ◽  
Access Site ◽  
Mortality And Morbidity ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Topic Patients with acute coronary syndrome undergoing primary percutaneous coronary intervention are at risk of clinical deterioration that results in similar general signs and symptoms regardless of its cause. However, specific causes and forms of clinical deterioration are associated with key differences in assessment findings. Focused clinical assessments using a modified primary survey enable nurses to rapidly identify the cause and form of clinical deterioration, facilitating targeted treatment. Clinical Relevance Clinical deterioration during percutaneous coronary intervention is associated with increased mortality and morbidity. Previous studies identified nursing inconsistencies when recognizing clinical deterioration, with inconsistent collection of cues and prioritization of cues related to cardiac performance over more sensitive indicators of clinical deterioration. Purpose of Paper To describe a framework to help nurses optimize physiological cue collection to improve recognition of clinical deterioration during periprocedural care of patients undergoing percutaneous coronary intervention for unstable acute coronary syndrome. Content Covered Literature analysis revealed 7 forms of clinical deterioration in patients undergoing percutaneous coronary intervention: coronary artery occlusion, stroke, ventricular rupture, valvular insufficiency, lethal cardiac arrhythmias, access-site and non–access-site bleeding, and anaphylaxis. Evidence for the pathophysiology, incidence, severity, and clinical features of each form of clinical deterioration is identified. A framework is proposed to help nurses conduct highly focused patient assessments, enabling prompt recognition of and response to the specific forms of clinical deterioration that occur in patients undergoing percutaneous coronary intervention.

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