Expanding Criteria for Same-Day Discharge after Mastectomy

Area of Science:

• Oncology
• Surgical Oncology
• Patient Outcomes

Background:

• Same-day discharge (SDM) after mastectomy is established as safe for select patients.
• An institutional feasibility study explored expanding SDM eligibility criteria.
• This study aimed to assess the safety and outcomes of an expanded SDM pathway.

Purpose of the Study:

• To evaluate the feasibility and safety of an expanded same-day discharge (SDM) pathway post-mastectomy.
• To compare outcomes between patients discharged the same day and those with overnight stays.
• To identify key factors influencing the success of SDM.

Main Methods:

• A prospective study collected data on mastectomy patients from February 2022 to May 2023.
• An SDM pathway was implemented with enhanced patient education and expectation management.
• Patient demographics, surgical details, complications, and patient-reported outcomes via Recovery Tracker were analyzed.

Main Results:

• Of 1664 patients, 84 (5%) underwent SDM, including conversions from planned overnight stays.
• SDM patients were older, more likely to have unilateral mastectomies, and less likely to have reconstruction compared to overnight patients.
• No significant difference in early complications; SDM patients had more 30-day complications, but no ER visits, transfers, or admissions were reported.

Conclusions:

• Same-day discharge (SDM) is safe for mastectomy patients, even with expanded eligibility criteria.
• Patient selection for SDM should prioritize motivation and clear expectations over age, surgery type, or distance.
• Effective communication between clinical teams and patients is crucial for successful SDM implementation.