Evaluation of safety and feasibility of ambulatory urogynaecological procedures in a 24-h setting

Arunkalaivanan, Angamuthu; Sajja, Anuradha; Kubal, Uma

doi:10.1007/s00192-010-1174-5

Cited by 1 publication

(5 citation statements)

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“…From 2010 to 2020, 79.1% of one surgeon's 1793 FPRS cases were discharged on the day of surgery, with no association found between same day discharge and 30‐day readmission or ED visits 8 . This finding further supports a growing body of literature demonstrating the advantages and minimal complications of same‐day discharge 4–6,8–10 …”

Section: Introductionmentioning

confidence: 52%

“…[4][5][6][8][9][10] However, the clinical benefits and financial savings associated with outpatient surgery are diminished when patients experience readmission and/or an extended hospital stay following outpatient surgery. 5 Both readmission rate and prolonged length of stay (LOS) have been used as indicators of quality of care in outpatient surgery. The Centers for Medicare and Medicaid Services (CMS) reduces payments to hospitals with excess readmissions.…”

Section: Introductionmentioning

confidence: 99%

“…Outpatient FPRS is an attractive option that can improve efficiency and decrease healthcare costs, while providing comparable safety and clinical outcomes 3 . Multiple studies of FPRS have validated the safety and efficacy of outpatient protocols, with greater than 77% success in ambulatory discharge 4–8 . From 2010 to 2020, 79.1% of one surgeon's 1793 FPRS cases were discharged on the day of surgery, with no association found between same day discharge and 30‐day readmission or ED visits 8 .…”

Section: Introductionmentioning

confidence: 99%

“…8 This finding further supports a growing body of literature demonstrating the advantages and minimal complications of same-day discharge. [4][5][6][8][9][10] However, the clinical benefits and financial savings associated with outpatient surgery are diminished when patients experience readmission and/or an extended hospital stay following outpatient surgery. 5 Both readmission rate and prolonged length of stay (LOS) have been used as indicators of quality of care in outpatient surgery.…”

Section: Introductionmentioning

confidence: 99%

“…3 Multiple studies of FPRS have validated the safety and efficacy of outpatient protocols, with greater than 77% success in ambulatory discharge. [4][5][6][7][8] From 2010 to 2020, 79.1% of one surgeon's 1793 FPRS cases were discharged on the day of surgery, with no association found between same day discharge and 30-day readmission or ED visits. 8 This finding further supports a growing body of literature demonstrating the advantages and minimal complications of same-day discharge.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of prolonged admission after outpatient female pelvic reconstructive surgery

Simi

Chapman

Zillioux

et al. 2022

Neurourology and Urodynamics

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This study aimed to determine factors associated with prolonged hospital admission following outpatient female pelvic reconstructive surgery (FPRS) and associated adverse clinical outcomes.Methods: Using the National Surgical Quality Improvement Program database, we identified outpatient FPRS performed 2011-2016. Isolated hysterectomy without concurrent prolapse repair was excluded. Surgeries were classified as major or minor for analysis. The primary outcome was prolonged length of stay (LOS), defined as admission of ≥2 days. Secondary outcomes included complications, readmission and reoperation associated with prolonged LOS. We abstracted data on covariates, and following univariable analysis, performed backward stepwise regression analysis.Results: A total of 29645 women were included: 12311 (41.5%) major and 17334 (58.5%) minor procedures. A total of 6.9% (2033) had a prolonged LOS.On full cohort multivariable regression analysis, patient characteristics associated with prolonged LOS were older age (odds ratio [OR]: 1.1 per 10 years, confidence interval [CI]: 1.06-1.1, p < 0.001), frailty (OR: 1.8, 95% CI:1.3-2.6, p = 0.001), and Caucasian race (OR: 1.2, CI: 1.02-1.3, p = 0.024). Associated surgical factors included having a major surgical procedure (OR:1.3, CI: 1.2-1.4, p < 0.001), use of general anesthesia (OR: 2.0, CI: 1.5-2.6, p < 0.001) and longer operative time (OR: 2.0, CI: 1.8-2.2, p < 0.001). The occurrence of any complication (10.3% vs. 4.7%, p < 0.001), hospital readmission (4.3% vs. 1.7%, p < 0.001), and reoperation (2.7% vs. 1.0%, p < 0.001) were more likely with prolonged LOS.Conclusions: After outpatient FPRS, 6.9% of patients experience an admission of ≥2 days. Prolonged LOS is more common in patients who are older, frail and Caucasian, and in those who have major surgery with long operative time and general anesthesia.

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Section: Introductionmentioning

confidence: 52%