Cassandra K Kisby1, Michael R Polin2, Anthony G Visco3, Nazema Y Siddiqui3. 1. From the Department of Obstetrics and Gynecology, Duke Hospital, Durham, NC. 2. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Tennessee Medical Center, Knoxville, TN. 3. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke Hospital, Durham, NC.
Abstract
OBJECTIVE: The aim of the study was to compare unplanned postoperative encounters in women discharged same day versus later after robotic-assisted sacrocolpopexy (RA-SCP). METHODS: This is a retrospective cohort study of women who underwent RA-SCP at a tertiary care center January 2013 to September 2015. Women were divided into 2 cohorts based on their day of discharge: (1) same day or (2) postoperative day 1 (POD ≥ 1) or later. Our primary outcome was unplanned provider visits (clinic, urgent care, emergency department, or hospital readmission) during the 6 weeks after surgery. Secondary outcomes included unplanned postdischarge nurse or physician phone calls. Logistic regression models were created to control for potential confounders. RESULTS: Two hundred seventy-two women were included; 80 underwent same-day discharge versus 192 discharged POD 1 or later (187 on POD 1, 5 on POD 2). Women discharged same day were older (61.3 vs 58.5 years, P < 0.05), more likely to have a start time before noon (85% vs 67.6%, P < 0.01), received less intraoperative intravenous fluids (1153 mL vs 1536 mL, P < 0.01), had shorter procedures (237 vs 256 minutes, P < 0.01), and spent more time in the postanesthesia care unit (213 vs 158 minutes, P < 0.01). There were no differences in unplanned provider visits between women discharged same day versus later (18.8% vs 27.6%, P = 0.12). No differences were observed in unplanned clinic visits, emergency department visits, or readmissions. In logistic regression models, unplanned provider visits (odds ratio = 0.35, 95% confidence interval = 0.30-1.54) and phone calls (odds ratio = 0.69, 95% confidence interval = 0.54-2.58) were not significantly different between groups. CONCLUSIONS: Same-day discharge after RA-SCP is safe and does not result in increased health care utilization (provider visits or postoperative phone calls).
OBJECTIVE: The aim of the study was to compare unplanned postoperative encounters in women discharged same day versus later after robotic-assisted sacrocolpopexy (RA-SCP). METHODS: This is a retrospective cohort study of women who underwent RA-SCP at a tertiary care center January 2013 to September 2015. Women were divided into 2 cohorts based on their day of discharge: (1) same day or (2) postoperative day 1 (POD ≥ 1) or later. Our primary outcome was unplanned provider visits (clinic, urgent care, emergency department, or hospital readmission) during the 6 weeks after surgery. Secondary outcomes included unplanned postdischarge nurse or physician phone calls. Logistic regression models were created to control for potential confounders. RESULTS: Two hundred seventy-two women were included; 80 underwent same-day discharge versus 192 discharged POD 1 or later (187 on POD 1, 5 on POD 2). Women discharged same day were older (61.3 vs 58.5 years, P < 0.05), more likely to have a start time before noon (85% vs 67.6%, P < 0.01), received less intraoperative intravenous fluids (1153 mL vs 1536 mL, P < 0.01), had shorter procedures (237 vs 256 minutes, P < 0.01), and spent more time in the postanesthesia care unit (213 vs 158 minutes, P < 0.01). There were no differences in unplanned provider visits between women discharged same day versus later (18.8% vs 27.6%, P = 0.12). No differences were observed in unplanned clinic visits, emergency department visits, or readmissions. In logistic regression models, unplanned provider visits (odds ratio = 0.35, 95% confidence interval = 0.30-1.54) and phone calls (odds ratio = 0.69, 95% confidence interval = 0.54-2.58) were not significantly different between groups. CONCLUSIONS: Same-day discharge after RA-SCP is safe and does not result in increased health care utilization (provider visits or postoperative phone calls).
Authors: Anna L Romanova; Charelle Carter-Brooks; Kristine M Ruppert; Halina M Zyczynski Journal: Am J Obstet Gynecol Date: 2019-11-13 Impact factor: 8.661
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