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Same-day discharge feasible after lower-limb revascularization in elderly
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One-day early discharge was feasible for elderly patients who underwent endovascular revascularization of lower extremities, according to data from the SENIOR-ER registry.
Researchers analyzed data from 477 consecutive patients who underwent endovascular revascularization with angioplasty, atherectomy and/or stenting for treatment of significant arterial stenosis and at least Rutherford class 3 claudication.
They stratified patients by age (70 years or older vs. younger than 70 years) and followed them up at 24 hours and 30 days. Twenty-two patients were excluded after failing to appear for 30-day follow-up, leaving 220 patients in the younger cohort (mean age, 61 years; 74% men) and 235 in the older cohort (mean age, 79 years; 55% men).
Same-day discharge occurred in all patients except for two in the older cohort who had pseudoaneurysms requiring surgery and one in the younger cohort who had retroperitoneal bleeding, Adam Janas, MD, PhD, from the Center for Cardiovascular Research and Development, American Heart of Poland in Katowice, Poland, and colleagues wrote.
At 24 hours, no one in either group had MACE or an increase in creatinine, according to the researchers. Mean time to ambulation did not differ between the groups (P = .6).
At 30 days, there were three cases of MACE — two amputations and one stroke — in the younger cohort but none in the older cohort, Janas and colleagues wrote.
Rate of access-site complications did not differ between the two groups.
“These results indicate that elderly patients undergoing [endovascular revascularization] of lower extremities could be considered for same-day discharge,” Janas and colleagues wrote. “Moreover, same-day discharge may help to avoid the development of delirium. However, the results of this study ought to be verified by conducting a prospective multicenter study because the findings have profound implications for the design of a clinical trial in this area.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
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