Readmission Rates after Same-Day Discharge Compared with Postoperative Day 1 Discharge after Benign Laparoscopic Hysterectomy

Abstract

Study objective: To determine if there is a difference in readmission rates after same-day discharge compared with postoperative day 1 discharges after laparoscopic hysterectomy.

Design: A retrospective cohort study with 1:2 propensity score matching (Canadian Task Force classification II-2).

Setting: American College of Surgeons National Surgical Quality Improvement Program database.

Patients: Women undergoing benign laparoscopic total or supracervical hysterectomy or laparoscopic-assisted vaginal hysterectomy with or without adnexal surgery between the years 2010 to 2015.

Interventions: Three thousand thirty-two low-risk women discharged on postoperative day 0 and 6064 women discharged on postoperative day 1 were included in the analysis.

Measurements and main results: The overall readmission rate was 1.8%; after same-day discharge, the readmission rate was 2.2%, and after postoperative day 1 discharge the readmission rate was 1.7% (p = .10). After logistic regression analysis, smoking (adjusted odds ratio [aOR] = 2.06; 95% confidence interval [CI], 1.49-2.88), nonwhite race (aOR = 1.53; 95% CI, 1.1007-2.14), and cystoscopy (aOR = 2.05; 95% CI, 1.49-2.82) were associated with an increased risk of readmission.

Conclusion: There was no statistically significant difference in readmission rates after laparoscopic hysterectomy between women discharged on the day of surgery or postoperative day 1.

Keywords: Hospital discharge; Laparoscopy; Readmission.