25 Changes in utilization and safety profile of same day discharge for minimally invasive hysterectomy from 2008-2018

To describe changes in same day discharges (SDDs) following minimally invasive hysterectomy (MIH) a large diverse practice population and to assess if utilization of SDD are associated with postoperative complications or unplanned readmission. We performed secondary analysis the 2008-2018 National Surgical Quality Improvement Program (NSQIP) Database. MIH were identified by current procedural terminology (CPT) code categorized approach: laparoscopic (TLH), vaginal (TVH), laparoscopic-assisted (LAVH). Individuals an oncologic diagnosis concomitant procedure other than adnexal surgery, who not discharged during 30-day period excluded from analysis. Change was assessed over 11-year using Cochran-Armitage test for trend. Overall odds readmission composite measures major minor logistic regression modeling, controlling patient characteristics. Interaction terms utilized temporal trends period. Notably, due missing data, only years 2011 2017 evaluated Secondary outcomes included superficial surgical site infection (SSI), any SSI, urinary tract (UTI) among SDD. There 161,444 hysterectomies Over period, there increase all forms (Figure 1), largest seen within TLH (+22.3%). However, 2018, discharge represented 21% overall varied approach (TLH 31%; LAVH 18%; TVH 19%). When including on post-operative 1, proportion cases increased 88.5 percent. no significant complications, while readmissions significantly decreased (absolute RR = 0.36%; Test P 0.019). compared individuals one, 25% lower readmission, 22 26% reduced complication respectively (Table 1). The last decade has MIH, which reductions rates complication. Moreover, noted suggesting that observed entirely attributable selection bias those offered These data suggest may have advantages inpatient admission after can be safely expanded larger portion undergoing MIH.