David Sheyn1, Sherif El-Nashar2, Megan Billow2, Sangeeta Mahajan2, Mary Duarte2, Robert Pollard3. 1. Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio. Electronic address: david.sheyn@uhhospitals.org. 2. Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio. 3. Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Metro Health Medical Center, Cleveland, Ohio.
Abstract
STUDY OBJECTIVE: To determine if there is a difference in readmission rates after same-day discharge compared with postoperative day 1 discharges after laparoscopic hysterectomy. DESIGN: A retrospective cohort study with 1:2 propensity score matching (Canadian Task Force classification II-2). SETTING: American College of Surgeons National Surgical Quality Improvement Program database. PATIENTS: Women undergoing benign laparoscopic total or supracervical hysterectomy or laparoscopic-assisted vaginal hysterectomy with or without adnexal surgery between the years 2010 to 2015. INTERVENTIONS: Three thousand thirty-two low-risk women discharged on postoperative day 0 and 6064 women discharged on postoperative day 1 were included in the analysis. MEASUREMENTS AND MAIN RESULTS: The overall readmission rate was 1.8%; after same-day discharge, the readmission rate was 2.2%, and after postoperative day 1 discharge the readmission rate was 1.7% (p = .10). After logistic regression analysis, smoking (adjusted odds ratio [aOR] = 2.06; 95% confidence interval [CI], 1.49-2.88), nonwhite race (aOR = 1.53; 95% CI, 1.1007-2.14), and cystoscopy (aOR = 2.05; 95% CI, 1.49-2.82) were associated with an increased risk of readmission. CONCLUSION: There was no statistically significant difference in readmission rates after laparoscopic hysterectomy between women discharged on the day of surgery or postoperative day 1.
STUDY OBJECTIVE: To determine if there is a difference in readmission rates after same-day discharge compared with postoperative day 1 discharges after laparoscopic hysterectomy. DESIGN: A retrospective cohort study with 1:2 propensity score matching (Canadian Task Force classification II-2). SETTING: American College of Surgeons National Surgical Quality Improvement Program database. PATIENTS: Women undergoing benign laparoscopic total or supracervical hysterectomy or laparoscopic-assisted vaginal hysterectomy with or without adnexal surgery between the years 2010 to 2015. INTERVENTIONS: Three thousand thirty-two low-risk women discharged on postoperative day 0 and 6064 women discharged on postoperative day 1 were included in the analysis. MEASUREMENTS AND MAIN RESULTS: The overall readmission rate was 1.8%; after same-day discharge, the readmission rate was 2.2%, and after postoperative day 1 discharge the readmission rate was 1.7% (p = .10). After logistic regression analysis, smoking (adjusted odds ratio [aOR] = 2.06; 95% confidence interval [CI], 1.49-2.88), nonwhite race (aOR = 1.53; 95% CI, 1.1007-2.14), and cystoscopy (aOR = 2.05; 95% CI, 1.49-2.82) were associated with an increased risk of readmission. CONCLUSION: There was no statistically significant difference in readmission rates after laparoscopic hysterectomy between women discharged on the day of surgery or postoperative day 1.
Authors: Elizabeth H Robison; Pamela E Smith; Lopa K Pandya; Silpa Nekkanti; Andrew F Hundley; Catherine O Hudson Journal: Int Urogynecol J Date: 2021-04-21 Impact factor: 1.932
Authors: Andrea M Simi; Graham C Chapman; Jacqueline Zillioux; Sarah Martin; Emily A Slopnick Journal: Neurourol Urodyn Date: 2022-03-29 Impact factor: 2.367