Comparison of Readmission Rates for Same-Day Versus Next-Day Discharge After Benign Vaginal Hysterectomy

Area of Science:

• Gynecology
• Surgical Outcomes
• Patient Discharge Practices

Background:

• Same-day discharge (SDD) is established as safe for laparoscopic hysterectomy.
• Data regarding the safety and efficacy of SDD for vaginal hysterectomy (VH) are limited.
• Understanding readmission rates is crucial for evaluating discharge protocols.

Purpose of the Study:

• To compare 30-day readmission rates between SDD and next-day discharge (NDD) after vaginal hysterectomy (VH).
• To analyze the timing and reasons for readmission following VH based on discharge timing.
• To evaluate the impact of prolapse repair on readmission rates for SDD versus NDD.

Main Methods:

• Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program database (2012-2019).
• Identification of VH cases using Current Procedural Terminology codes.
• Statistical analysis including univariate and multivariate analyses to determine odds ratios for 30-day readmissions.

Main Results:

• A total of 24,277 women were included, with 16.8% undergoing SDD.
• The overall 30-day readmission rate was low (2.0%) and did not differ significantly between SDD and NDD groups (adjusted odds ratio [aOR], 0.9; 95% CI, 0.7-1.2).
• Common readmission reasons included bleeding, infection, bowel obstruction, pain, and nausea/emesis; median time to readmission was similar for both groups.

Conclusions:

• Same-day discharge after vaginal hysterectomy does not increase the odds of 30-day readmission compared to next-day discharge.
• These findings support the implementation of same-day discharge for carefully selected low-risk patients undergoing benign vaginal hysterectomy.
• Further research may explore patient selection criteria to optimize SDD safety and efficacy.