Abstract 2867: Complications at the Vascular Access Site in the First Week Following Elective Cardiac Catheterization or Percutaneous Coronary Intervention
The most common complication(s) of cardiac catheterization (CATH) and/or Percutaneous Coronary Intervention (PCI) occur at the vascular access (VA) site. Major complications are usually evident before discharge, however the incidence of VA complications in the early post-discharge period is unclear. The primary purpose of this prospective cohort study was to identify the number and type of VA complications in the early (5–7 day) post-discharge period following elective CATH and/or PCI. Secondary outcomes of interest were, utilization of health care services after discharge related to VA complications and patient adherence to a new prescription for Clopidogrel. One hundred and seventy nine eligible patients were recruited into the study between November and December 2005. Data sources were:
discharge assessment of VA site and
telephone follow up 5–7 days post procedure.
Complete data were available for 172 participants. The sample included 110 males and 62 females with a mean telephone follow-up time of 5.09 days. There were no major complications at discharge or at the 5–7 day follow-up. At the time of follow-up 68.6% of patients (n=118) reported bruising at their VA site. Of these, 47% reported bruising larger than the size of a tennis ball. Seven patients (4.2%) sought medical advice related to their VA site following discharge. On discharge 22.1% of patients were given a new prescription for Clopidogrel; 100% of these reported filling the prescription. Bivariate analysis revealed a significant association between female sex and post discharge bruising (Chi-square 10.490, p= .001), with a likelihood ratio of 11.20. The use of Abciximab during the procedure was also associated with post discharge bruising, (Fisher’s Exact Test, p= .045). Regression analysis revealed sex as a significant predictor of bruising 5–7 days after discharge (p= .001). This study is consistent with other research suggesting major complications after elective CATH and/or PCI are rare. The findings further indicate that a large number of patients may go on to experience significant bruising at the VA site after discharge. Understanding the extent of bruising and its predictors, will aid nurses in tailoring discharge teaching related to VA site complications.