Minimally Invasive Sacrocolpopexy-Which Patients Are Likely to Stay Overnight?

Area of Science:

• Urology and Gynecology
• Surgical Outcomes Research
• Health Services Research

Background:

• Minimally invasive sacrocolpopexy (MISC) is a successful treatment for pelvic organ prolapse.
• Same-day discharge (SDD) after MISC offers potential cost savings compared to observation/admission (O/A).
• Understanding predictors of O/A versus SDD is crucial for healthcare efficiency.

Purpose of the Study:

• To identify risk factors associated with observation/admission (O/A) versus same-day discharge (SDD) in patients undergoing MISC.

Main Methods:

• Retrospective cohort study of 798 patients undergoing MISC from 2018-2023.
• Univariate and multivariate logistic regression analyses were used to identify independent factors for O/A.
• Statistical significance was set at P < 0.05.

Main Results:

• 537 patients (67%) were discharged the same day (SDD), while 261 (33%) required observation/admission (O/A).
• Independent predictors for O/A included "other" race, late surgical start time, increased operative time, higher pain scores, and higher American Society of Anesthesiologists (ASA) classification.
• O/A was linked to more unplanned visits, increased office messages, and fewer catheters at discharge.

Conclusions:

• Several patient and surgical factors predict the need for observation/admission after MISC.
• Identifying these factors can improve patient counseling, expectation management, and surgical scheduling.
• Further research is needed to quantify cost implications and patient satisfaction related to discharge status.