Safety and Outcomes of Same-Day Discharge After Elective Cardiac Catheterization for Congenital Heart Disease: A Single-Center Propensity-Matched Cohort Study.

BACKGROUND

Overnight observation remains the conventional disposition after elective catheterization for congenital heart disease, although most elective procedures can be performed without significant complication. We evaluated the safety of same-day discharge (SDD) after elective congenital cardiac catheterization at a single tertiary center.

AIMS: We aimed to evalute the safety and outcomes of same-day discharge (SDD) after elective cardiac catheterization for congenital heart disease at a single tertiary center and to compare SDD with overnight admission using propensity score matching.

METHODS

We performed a retrospective cohort study of elective catheterizations between January 2023 and April 2026. Patients discharged home the same day (same-day discharge, SDD, n = 54) were compared with patients admitted for at least one night (delayed discharge, DD, n = 551) following elective procedures. Outcomes included in-hospital adverse events and, for the SDD cohort, 30-day emergency department (ED) visits and readmissions. A 1:1 propensity score-matched analysis (age, weight, sex, oxygen saturation, hemoglobin, and interventional procedure) was performed.

RESULTS

SDD patients were older (median 10.4 vs. 3.9 years, p < 0.001), larger (31.0 vs. 14.9 kg, p < 0.001), less often underwent an interventional procedure (42.6% vs. 78.7%;p < 0.001), and shorter procedure duration (64 vs. 111 min, p < 0.001) as compared to the admission group. Median post-procedure observation was 6.1 h (IQR, 5.1-7.0) and total facility time 10.5 h (IQR). No in-hospital adverse events occurred among SDD patients, compared with 36 (5.9%) DD patients (p = 0.11). Within 30 days of SDD, 2 patients (3.7%) had an ED visit and 4 (7.4%) were readmitted (6 encounters); one readmission (1.9%) was procedure-related, a femoral pseudoaneurysm managed under observation. In 52 matched pairs, no in-hospital adverse events occurred in either group; median length of stay was 0 versus 1 day (p < 0.001); and 30-day all-cause readmission occurred in 3 (5.8%) SDD versus 6 (11.5%) DD cohorts (p = 0.054).

CONCLUSIONS

In carefully selected, predominantly lower-risk patients, SDD after elective congenital cardiac catheterization was not associated with in-hospital adverse events or excess procedure-related 30-day morbidity. SDD may safely reduce hospital resource utilization in this population; however, the small sample size, selection bias, and residual confounding limit conclusions regarding broader safety or equivalence with overnight observation.