title: Same-day discharge after laparoscopic hysterectomy.
abstract: OBJECTIVE
  To estimate readmission rates and emergency care use by patients discharged home the same day after laparoscopic hysterectomy.
  
  
  METHODS
  This was a retrospective case series of patients discharged home the same-day after total or supracervical laparoscopic hysterectomy in a managed care setting. Chart reviews were performed for outcomes of interest which included readmission rates, emergency visits, and surgical and demographic characteristics. The two hysterectomy groups were compared using χ² tests for categorical variables and t tests or Wilcoxon rank-sum tests for continuously measured variables.
  
  
  RESULTS
  One-thousand fifteen laparoscopic hysterectomies were performed during the 3-year study period. Fifty-two percent (n=527) of the patients were discharged home the same-day; of those, 46% (n=240) had total laparoscopic hysterectomies and 54% (n=287) had supracervical. Cumulative readmission rates were 0.6%, 3.6%, and 4.0% at 48 hours, 3 months, and 12 months, respectively. The most common readmission diagnoses included abdominal incision infection, cuff dehiscence, and vaginal bleeding. Less than 4% of patients presented for emergency care within 48 or 72 hours, most commonly for nausea or vomiting, pain, and urinary retention. Median uterine weight was 155 g, median blood loss was 70 mL, and median surgical time was 150 minutes. There was no difference in readmission rates or emergency visits for the total compared with the supracervical laparoscopic hysterectomy group.
  
  
  CONCLUSIONS
  Same-day discharge after laparoscopic hysterectomy is associated with low readmission rates and minimal emergency visits in the immediate postoperative period. Same-day discharge may be a safe option for healthy patients undergoing uncomplicated laparoscopic hysterectomy.
authors.affiliation: From the Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, Oakland, Oakland, California.
authors.forename: Misa
authors.initials: M
authors.lastname: Perron-Burdick
authors.forename: Miya
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Eve
authors.initials: E
authors.lastname: Zaritsky
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D012189:Retrospective Studies