This document discusses the economic and clinical benefits of transitioning to radial access outpatient percutaneous coronary interventions (PCI). It notes that PCI is no longer reimbursed under diagnosis-related groups and hospitals are incentivized to reduce length of stay. Studies show same-day discharge after radial PCI is as safe as overnight admission and can reduce costs by over $1,000 per patient. Radial access also significantly reduces vascular complications compared to femoral access. The document argues radial PCI enables more efficient care delivery models like same-day discharge, improving both patient outcomes and hospital finances.
11. Icg 2015
Favors
Same Day Overnight
0.01 0.1 1 10 100
Same Day v Overnight
30 Day Outcome
Complications MACE Hospitalization
RCT
n=5
Observational
n=8
Odds Ratio
Mantel-Haenszel Random effect, 95% CI
§ Despite analysis of >110,000 patients, unable to resolve a difference
§ A non-inferiority design with a sample size of > 320,000 patients needed for
certainty
JACC: Cardiovascular Interventions 2013; 6(2):99-112.
Favors
Same Day Overnight
0.01 0.1 1 10 100
Favors
Same Day Overnight
0.01 0.1 1 10 100
Subtotal
(95% CI)
Subtotal
(95% CI)
Total (95% CI)