The American College of Cardiology (ACC) recently issued guidelines for when a patient can be safely discharged home on the same day of a percutaneous coronary intervention. The most common of such procedures is known as angioplasty, a non-surgical procedure that uses a catheter (a thin flexible tube) to place a small structure called a stent to open up blood vessels in the heart that have been narrowed by plaque buildup, a condition known as atherosclerosis. The guidelines suggest that same day discharge after cardiac procedures is safe in many patients.

Currently, in fewer than 5% of such procedures in the U.S. result in patients discharged on the same day. Reasons for same-day discharge include patient preference, safety (avoiding hospital-acquired infections, and financial savings. The guidelines reflect an increasing trend toward shorter hospital stays after medical procedures. 

The ACC guidelines emphasize that there are safety factors to consider in each case, such as availability of a caregiver after discharge, whether there were complications during the procedure, and patient education on monitoring the catheter access site.

The ACC group acknowledged that there is lingering uncertainty about the safety of same-day discharge, since there have been only a few randomized trials. However, the observational evidence points toward no increase in death, re-hospitalization, or other complications. 

The guidelines likewise recognize the increasing efficiency (read: cost savings) that come with a same day discharge, when compared to keeping a patient over night. Once the patient is thoroughly evaluated and cleared for discharge this may lead, according to the ACC, to some $200-$500 million saved. It’s not clear who saves this money, but I think its safe to assume that ints insurers that will be