Vascular Complications from Coronary Angiography/Percutaneous Coronary Intervention: Comparing Day Case Patients and Inpatients in a Tertiary Hospital in Thailand: A Retrospective Cohort Study

Authors

  • Chantana Charoensin Naradhiwas Rajanagarindra Heart Center, Faculty of Medicine, Prince of Songkla University, Songkhla 90110,
  • Ratchanee Srichai Naradhiwas Rajanagarindra Heart Center, Faculty of Medicine, Prince of Songkla University, Songkhla 90110,
  • Thammasin Ingviya Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110,

DOI:

https://doi.org/10.31584/jhsmr.2020739

Keywords:

cardiac catheterization, day case, percutaneous coronary intervention, vascular complications

Abstract

Objective: To compare the incidence along with risk factors of vascular complications between patients having undergone Coronary angiography/Percutaneous Coronary Interventions (CAG/PCIs); as day cases and those as inpatients.
Material and Methods: Our study is a retrospective cohort study. We performed a retrospective chart review of the patients, visiting a heart center of the hospital from October, 2014 to September, 2018. We included patients of a minimum 18 years of age, who had undergone CAG/PCIs. Excluded patients were those who had been referred from other hospitals. The main outcomes were vascular complications defined as: (1) bleeding with significant blood loss during the procedure. (2) Hematoma within 1 month after the procedure. Wilcoxon’s rank sum and chi-squared test were used to assess the risk factors.
Results: Of all 784 patients having undergone CAG/PCI, 387 were day cases and 397 were inpatients. Only 12 cases developed vascular complications. The incidence of vascular complications was not significantly different between either day case; whose incidence was 1.3% (95% confidence interval (CI), 0.72-1.87), and inpatients; whose incidence was 1.8% (95% CI, 1.10-2.42). We found that the risk factors of vascular complications were percutaneous coronary intervention, and using a vascular closure device to remove the introducer sheath.
Conclusion: Performing CAG/PCI as day cases did not increase the risks of complications post-procedure, as compare to the inpatients. However, due to the small numbers of patients with complications future studies with more patients are needed to ensure the safety of day case CAG/PCI. Patients undergoing PCI, or patients with vascular closure devices used should be closely observed before discharge.

References

1. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000;36:959–69.

2. Baim DS, Grossman W. Complications. In: Baim DS, Grossman W, editors. Grossman’s cardiac catheterization. 8th ed. Philadelphia: Lippincott Williums and Wilkins; 2000;p.65.

3. Muthusamy P, Busman DK, Davis AT, Wohns DH. Assessment of clinical outcomes related to early discharge after elective percutaneous coronary intervention: COED PCI. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv 2013;81:6–13.

4. Rao SV, Kaltenbach LA, Weintraub WS, Roe MT, Brindis RG, Rumsfeld JS, et al. Prevalence and outcomes of sameday discharge after elective percutaneous coronary intervention among older patients. JAMA 2011;306:1461–7.

5. Brayton KM, Patel VG, Stave C, de Lemos JA, Kumbhani DJ. Same-day discharge after percutaneous coronary intervention: a meta-analysis. J Am Coll Cardiol 2013;62:275–85.

6. Chambers CE, Dehmer GJ, Cox DA, Harrington RA, Babb JD, Popma JJ, et al. Defining the length of stay following percutaneous coronary intervention: an expert consensus document from the Society for Cardiovascular Angiography and Interventions. Endorsed by the American College of Cardiology Foundation. Catheter Cardiovasc Interv 2009;73:847–58.

7. Ramharrack DV, Jurgens CY, Shlofmitz RA. Phenotype of same-day-discharge patients after percutaneous coronary intervention. J Cardiovasc Nurs 2018;33:160–7.

8. Shroff A, Kupfer J, Gilchrist IC, Caputo R, Speiser B, Bertrand OF, et al. Same-day discharge after percutaneous coronary intervention: current perspectives and strategies for mmplementation. JAMA Cardiol 2016;1:216–23.

9. Bundhun PK, Soogund MZS, Huang W-Q. Same day discharge versus overnight stay in the hospital following percutaneous coronary intervention in patients with stable coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. PLOS ONE 2017;12:e0169807

10. Seto AH, Shroff A, Abu-Fadel M, Blankenship JC, Boudoulas KD, Cigarroa JE, et al. Length of stay following percutaneous coronary intervention: an expert consensus document update from the society for cardiovascular angiography and interventions. Catheter Cardiovasc Interv 2018;92:717–31.

11. Supa J, Ratchanee N. Factors related to the occurrence of vascular complications among patients receiving percutaneous coronary Interventions via the Femoral Artery. APHEIT J 2017;6:14–24.

12. Applegate RJ, Grabarczyk MA, Little WC, Craven T, Walkup M, Kahl FR, et al. Vascular closure devices in patients treated with anticoagulation and iib/iiia receptor inhibitors during percutaneous revascularization. J Am Coll Cardiol 2002;40:78–83.

13. Christensen BV, Manion RV, Iacarella CL, Meyer SM, Cartland JL, Bruhn-Ding BJ, et al. Vascular complications after angiography with and without the use of sandbags. Nurs Res 1998;47:51–3.

14. Dangas G, Mehran R, Kokolis S, Feldman D, Satler LF, Pichard AD, et al. Vascular complications after percutaneous coronary interventions following hemostasis with manual compression versus arteriotomy closure devices. J Am Coll Cardiol 2001;38:638–41.

15. Nikolsky E, Mehran R, Halkin A, Aymong ED, Mintz GS, Lasic Z, et al. Vascular complications associated with arteriotomy closure devices in patients undergoing percutaneous coronary procedures. J Am Coll Cardiol 2004;44:1200–9.

16. Elzik ME, Dirschl DR, Dahners LE. Correlation of transfusion volume to change in hematocrit. Am J Hematol 2006;81:145–6.

17. Al Sadi AKA, Omeish AFY, Al-Zaru IM. Timing and predictors of femoral haematoma development after manual compression of femoral access sites. JPMA J Pak Med Assoc 2010;60:620–5.

18. Shao J, Chow SC, Wang H. Sample size calculations in clinical research. 2nd ed. Florida: CRC Press; 2003.

19. Yates F. Contingency table involving small numbers and the χ2 test. J R Stat Soc 1934;(Suppl 1):S217–35.

20. Abdelaal E, Rao SV, Gilchrist IC, Bernat I, Shroff A, Caputo R, et al. Same-day discharge compared with overnight hospitalization after uncomplicated percutaneous coronary intervention: a systematic review and meta-analysis. JACC Cardiovasc Interv 2013;6:99–112.

21. Koch KT, Piek JJ, Winter RJ de, David GK, Mulder K, Lie KI. Short-term (4 Hours) observation after elective coronary angioplasty. Am J Cardiol 1997;80:1591–4.

22. Jones T, McCutcheon H. A randomised controlled trial comparing the use of manual versus mechanical compression to obtain haemostasis following coronary angiography. Intensive Crit Care Nurs 2003;19:11–20.

23. Lehmann KG, Heath-Lange SJ, Ferris ST. Randomized comparison of hemostasis techniques after invasive cardiovascular procedures. Am Heart J 1999;138:1118–25.

24. Sekhar A, Sutton BS, Raheja P, Mohsen A, Anggelis E, Anggelis CN, et al. Femoral arterial closure using ProGlide® is more efficacious and cost-effective when ambulating early following cardiac catheterization. Int J Cardiol Heart Vasc 2016;13:6–13.

25. Capasso VA, Codner C, Nuzzo-Meuller G, Cox EM, Bouvier S. Peripheral arterial sheath removal program: a performance improvement initiative. J Vasc Nurs 2006;24:127–32.

26. Walker SB, Cleary S, Higgins M. Comparison of the Femo Stop device and manual pressure in reducing groin puncture site complications following coronary angioplasty and coronary stent placement. Int J Nurs Pract 2001;7:366–75.

Downloads

Published

2020-05-05

How to Cite

1.
Charoensin C, Srichai R, Ingviya T. Vascular Complications from Coronary Angiography/Percutaneous Coronary Intervention: Comparing Day Case Patients and Inpatients in a Tertiary Hospital in Thailand: A Retrospective Cohort Study. J Health Sci Med Res [Internet]. 2020 May 5 [cited 2024 Apr. 19];38(3):203-12. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/244166

Issue

Section

Original Article