Same-day discharge after sacrocolpopexy is feasible and may lower high-grade complications

A recent study found that same-day discharge (SDD) following minimally invasive sacrocolpopexy (SCP) was safe for patients with pelvic organ prolapse.¹ The findings were presented at the 2023 American Urological Association Annual meeting in Chicago, Illinois.

Patients who were discharged on the same-day were less likely to have diabetes (P < .01) or hypertension requiring medications (P < .001).

“You invite the opportunity for complications if someone stays in the hospital for longer. I think the idea is just getting them out earlier would be better,” said lead author Tal Cohen, MD, in a presentation on the results. Cohen is a chief urology resident at Stony Brook Medicine in New York.

Data for the study were collected using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2012 to 2020. Patients who were discharged on post-operative day 0, classified as SDD, were compared with those who were discharged on post-op day 1 or 2.

In total, 17,723 patients who underwent SCP were included for analysis. Of those, 3112 (17.6%) were discharged on post-op day 0. Investigators found a significant association between SDD and year of SCP (P < .001), with 31% of patients who underwent SCP in 2020 being discharged on post-op day 0, compared with only 10% in 2012.

Patients who were discharged on the same-day were less likely to have diabetes (P < .01) or hypertension requiring medications (P < .001). SDD patients were also younger compared with those discharged on day 1 or 2.

Data showed that SDD lessened the risk of serious complications in patients undergoing SCP. Those who were discharged on post-op day 0 had fewer instances of readmissions (P < .01) and fewer high-grade (class III-IV) complications (P < .05), particularly deep vein thrombosis requiring therapy. 

“Same-day discharges were, however, more likely to have superficial surgical site infections. This may indicate a greater need for education on wound care in these patients that are being discharged post-op day 0,” stated Cohen.

The authors concluded, “With further patient education on wound care, SDD after minimally invasive SCP may be a safe and less costly alternative in the surgical management of pelvic organ prolapse.”

Reference

1. Cohen T, Aalami Harandi A, Kim J. Minimally Invasive Sacrocolpopexy: Trends and Safety of Same-Day Discharge. Presented at: American Urological Association Annual Meeting, April 28-May 1, Chicago. Abstract MP07-08