Early discharge after percutaneous intervention - we can but should we?

摘要

In developed nations such as Australia and New Zealand, which have comprehensive public health insurance systems, there is an ever-present tension between the desire to provide optimal health care and the cost of doing so. Thus we continually search for more efficient ways to deliver health care. Intervention cardiology incurs significant public cost and hence the attraction of innovations, which can limit that cost.The proposal that we can discharge patients on the same day after percutaneous intervention (PCI) is one such innovation, but is it one that we should adopt? The report by Dr Herman in this issue of the Journal supports this initiative [1]. Their conclusions are similar to those of a number of previous international reports [2,3]. Another randomised trial of early discharge after elective PCI, involving 800 patients found no difference in 24 hour mortality or major adverse events between those randomised to early discharge and those randomised to overnight stay [4].