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Evaluating the association of same-day discharge following minimally invasive surgery for prolapse on 30-day postoperative adverse events

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Abstract

Introduction and hypothesis

The objective was to evaluate the association of same-day discharge and outcomes following minimally invasive surgery for pelvic organ prolapse (POP).

Methods

Using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database, we identified women undergoing POP surgery between 2014 and 2018 who were discharged on the day of surgery (same-day) or on postoperative day 1 (POD1). Patient and procedural characteristics, and 30-day outcomes including readmission, reoperation, and postoperative complications, were abstracted. Multivariate logistic regression was used to determine the association of day of discharge and complications, readmission, and reoperation while controlling for potential confounders.

Results

A total of 33,614 patients met the inclusion criteria: 20% patients were discharged on the same day, whereas 80% were discharged POD1. The mean ± SD age for the cohort was 61 ± 12 years, with a median (IQR) body mass index (BMI) of 28 (25–32) kg/m2. The overall postoperative complication rate was 5.4%. Patients discharged on the same day had lower rates of complications (4.8% vs 5.5%, p = 0.02) and lower rates of readmission (1.6% vs 2.0%, p = 0.03) compared with those discharged on POD1. No difference in reoperation rates (0.9% vs 1.1%, p = 0.31) were noted between groups. In multivariate logistic regression models controlling for age, race, BMI, ASA class, smoking, procedure type, and operative time, day of discharge was not associated with increased odds of postoperative complications (same-day discharge: aOR 1.00, 95% CI 0.88–1.14), reoperation (aOR 0.83, 95%CI 0.61–1.12), or readmission (aOR 0.93, 95%CI 0.74–1.16).

Conclusions

Same-day discharge did not impact the rate of adverse events after minimally invasive prolapse surgery.

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Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Obstetrics & Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    C. Emi Bretschneider & Kimberly Kenton

  2. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, Duke University, Durham, NC, USA

    Doug Luchristt

  3. Division of Female Pelvic Medicine and Reconstructive Surgery, Urology Institute, University Hospitals, Cleveland, OH, USA

    David Sheyn

Authors
  1. C. Emi Bretschneider
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  2. Doug Luchristt
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  4. David Sheyn
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Contributions

C.E.B.: concept development, data analysis, manuscript writing and editing; D.L.: manuscript editing; K.K.: manuscript editing; D.S.: concept development, manuscript writing and editing.

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Correspondence to C. Emi Bretschneider.

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The authors report no conflicts of interest. C.E.B. is a consultant for Boston Scientific; K.K. is an expert witness for Butler Snow and Ethicon. The other authors do not have any relevant disclosures.

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Bretschneider, C.E., Luchristt, D., Kenton, K. et al. Evaluating the association of same-day discharge following minimally invasive surgery for prolapse on 30-day postoperative adverse events. Int Urogynecol J 33, 1849–1856 (2022). https://doi.org/10.1007/s00192-021-05035-y

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  • DOI: https://doi.org/10.1007/s00192-021-05035-y

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