Same-day Discharge for Cleft Palate Repair: A Single-Surgeon Retrospective Analysis

Abstract

Objective To evaluate the safety of same-day discharge for patients undergoing primary cleft palate repair Design Single-surgeon retrospective review Setting Tertiary care institution Patients/Participants 40 consecutive patients that underwent primary cleft palate repair by a single surgeon from September 2018 to June 2023 Interventions Same-day discharge versus overnight admission after primary palatoplasty Main Outcome Measures 30-day readmission, reoperation, wound and all-cause complication rate and 1-year fistula incidence Results Of 40 total cases, 20 patients were discharged on the same calendar day and 20 patients were admitted for overnight stay following primary cleft palate repair. In the same-day discharge group, readmission incidence was 10%(n = 2), wound complication incidence was 5%(n = 1), and postoperative complication incidence was 15%(n = 3). In comparison, patients admitted overnight had a readmission incidence of 5%(n = 1, P = 1.00), wound complication incidence of 10%(n = 2, P = 1.00), and postoperative complications of 20%(n = 4, P = 1.00) No patients had 30-day reoperations or fistulas at 1 year. A higher proportion of admitted patients held a preoperative diagnosis of unilateral cleft palate and alveolus (Veau 3) as compared to patients discharged on the same day ( P = .019). During the postoperative hospital course, admitted patients received significantly more oxycodone at median of 2 doses (IQR 1.00–3.75) and acetaminophen at a median of 4 doses (IQR 3.00–5.00) than patients with same-day discharge with a median of 1 dose (IQR 0.00 –1.00, P < .001). Conclusions In a low-risk patient population, same-day discharge following primary cleft palate repair may be safely undertaken and result in similar short-term outcomes and 1-year fistula incidence as patients admitted for overnight stay.