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Readmissions and perioperative outcomes for same-day versus next-day discharge after prolapse surgery

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Abstract

Introduction and hypothesis

We aimed to evaluate the safety of same-day discharge (SDD) compared with next-day discharge (NDD) after prolapse surgery on a national level hypothesizing that readmission and complication rates after SDD would not be higher than NDD.

Methods

We performed a retrospective cohort study using the National Surgical Quality Improvement Program database including 2014-2018. Current Procedural Terminology (CPT) codes were used to identify minimally invasive apical suspensions or obliterative procedures. Exclusion criteria were length of stay > 1 day, unrelated concomitant procedures, serious medical comorbidities, American Society of Anesthesiologists (ASA) Class >2, and complication during index admission. The primary outcome was 30-day readmission, and secondary outcomes included 30-day complications.

Results

12,583 were included in analysis. SDD rate was 16.7%. The majority of women were white (91%) with a mean age of 59 years and mean body mass index of 28 kg/m². Medical comorbidities were similar between the SDD and NDD groups. Overall incidence of 30-day readmission was 1.7%. SDD had lower odds of 30-day readmission than NDD (aOR 0.63, 95% CI 0.41–0.98). SDD had lower odds of 30-day complications but this failed to reach statistical significance (aOR 0.67, 95% CI 0.44–1.03).

Conclusions

In this cohort, 30-day readmission and complication rates were not higher after SDD compared to NDD in women undergoing minimally-invasive apical suspension or obliterative procedures. We interpret these findings carefully given study limitations but believe our findings support the safety of SDD after minimally invasive apical suspension or obliterative procedures in a low-risk population.

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Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, The Ohio State University Wexner Medical Center, 395 W 12th Ave, Floor 5, Columbus, OH, 43210, USA

    Elizabeth H. Robison, Pamela E. Smith, Lopa K. Pandya, Silpa Nekkanti, Andrew F. Hundley & Catherine O. Hudson

  2. Division of Female Pelvic Medicine and Reconstructive Surgery, University of Illinois, Chicago, Chicago, IL, USA

    Lopa K. Pandya

Authors
  1. Elizabeth H. Robison
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  2. Pamela E. Smith
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  3. Lopa K. Pandya
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  4. Silpa Nekkanti
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  5. Andrew F. Hundley
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  6. Catherine O. Hudson
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Contributions

EH Robison: Study design, cohort development, data analysis, manuscript writing.

PE Smith: Study design, manuscript writing and editing.

LK Pandya: Study design, manuscript writing and editing.

S Nekkanti: Study design, manuscript writing and editing.

AF Hundley: Study design, manuscript writing and editing.

CO Hudson: Study design, cohort development, data analysis, manuscript writing.

Corresponding author

Correspondence to Elizabeth H. Robison.

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Cite this article

Robison, E.H., Smith, P.E., Pandya, L.K. et al. Readmissions and perioperative outcomes for same-day versus next-day discharge after prolapse surgery. Int Urogynecol J 33, 1897–1905 (2022). https://doi.org/10.1007/s00192-021-04799-7

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  • DOI: https://doi.org/10.1007/s00192-021-04799-7

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