Same-day discharge vs hospital admission after cardiac device implantations: a systematic review and meta-analysis. (14th October 2021)

• Record Type: Journal Article
• Authors: Trongtorsak, A; Kewcharoen, J; Thangjui, S; Worapongsatitaya, P; Yodsuwan, R; Navaravong, L
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Device Treatment; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.0403
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Due to the increasing need for cardiac device implantations, the cost of healthcare has been rising. This includes the cost of hospital stay after the procedure. Thus, we conducted this systematic review and meta-analysis to assess the safety and feasibility of same-day discharge (SDD) after cardiac device implantations. Methods: We searched MEDLINE, and Embase databases from inception to March 2021 to identify studies that compared clinical outcomes between SDD group and hospital overnight stay (HO) group after cardiac device implantations. Outcomes included complications after the procedure, mortality, and rehospitalization. Data from each study were combined using the random-effects model to calculate pooled odds ratio (OR) with 95% confidence interval (CI). Results: Six studies (1 randomized control trial, 1 prospective cohort study and 4 retrospective cohort studies) with a total of 59, 312 patients were included. SDD was not associated with more procedure-related complications. The pooled ORs for wound problems, pneumothorax, hematoma, and lead dislodgement/repositioning were 0.86 (95% CI: 0.2–3.68, p=0.834), 1.36 (95% CI: 0.26–7.12, p=0.718), 0.35 (95% CI: 0.01–9.85, p=0.534), and 1.71 (95% CI: 0.64–4.54, p=0.281) respectively. Readmission rate (pooled OR= 1.38, 95% CI: 0.51–3.69, p=0.524) and mortality rate (pooled OR= 0.86, 95% CI: 0.62–1.2, p=0.383) were similar between both groups. As shown in figure 1. Conclusions: Our meta-analysis suggested that same-day discharge after cardiac device implantations is a safe and feasible alternative to a hospital overnight stay strategy. Funding Acknowledgement: Type of funding sources: None.