Factors that Lengthen Patient Hospitalizations Following Laparoscopic Hysterectomy

Area of Science:

• Gynecologic Surgery
• Surgical Outcomes
• Hospital Administration

Background:

• Prolonged hospitalization after laparoscopic hysterectomy presents challenges.
• Pre-Enhanced Recovery After Surgery (ERAS) protocols, factors influencing length of stay require identification.

Purpose of the Study:

• To describe factors associated with prolonged hospitalization after laparoscopic hysterectomy before ERAS implementation.
• To identify areas for improvement in surgical recovery pathways.

Main Methods:

• Retrospective cohort study of 384 patients undergoing various laparoscopic hysterectomies for benign conditions (2010-2015).
• Evaluation of patient, surgical, and physician factors impacting length of hospitalization.
• Analysis conducted at three academic hospitals in the southeastern United States.

Main Results:

• 19.5% of patients experienced prolonged hospitalization (defined as >1 day).
• Robotic-assisted total laparoscopic hysterectomy (aOR 3.13) was associated with increased risk.
• Postoperative nausea or vomiting (aOR 2.01), dietary restrictions (aOR 4.42), and complications (aOR 3.58) significantly increased hospitalization duration.

Conclusions:

• Findings highlight the need for ERAS protocols to optimize recovery.
• Targeting postoperative nausea/vomiting and implementing early feeding are key interventions.
• Patient and provider education on ERAS protocols is crucial for reducing length of stay.