Feasibility of Same Day Mastectomy Discharge in a Safety Net Hospital in Memphis, TN

Prior to the pandemic, patients undergoing mastectomy were typically admitted overnight for observation, pain control, and next day wound check in our healthcare system. The objective of this study is to assess the feasibility and safety of same day mastectomy discharge for patients based on clinical and social determinants of health (SDH) in a safety net hospital.

A retrospective study was performed for patients who underwent mastectomy between 2021 and 2024. Demographics, clinical characteristics, SDH and outcomes were abstracted, and patients were stratified into 2 groups: same day discharge and admission following mastectomy.

44 charts were reviewed with 26 (59.0%) patients discharged on the day of surgery and 18 (41.0%) patients admitted following surgery. Neoadjuvant chemotherapy, pain control pre or post operatively, and tumor size were all found not to be statistically significant indicators of same day discharge. Patients who were not admitted had a higher rate of employment (70.0%) compared to those who were admitted (42.9%) (P value = .1). Patients admitted lived closer to the hospital as compared to patients who were discharged on the same day (8.2 miles vs. 10.6 miles, P value = .2). Primary language, disability status, substance use, food or transportation insecurity were all found not to be statistically significant.

Same day discharge is achievable for patients' undergoing mastectomy at safety net hospitals due to improvements in pain management and SDH screening. Prior to operation, patients should have appropriate screening to better understand who may benefit from admission following procedure.