title: Comparison of perioperative outcomes in outpatient and inpatient laparoscopic hysterectomy.
abstract: OBJECTIVE
  To compare 30-day postoperative outcomes in outpatient and inpatient laparoscopic hysterectomy procedures.
  
  
  METHODS
  Retrospective observational study (Canadian Task Force classification II-2).
  
  
  METHODS
  More than 250 hospitals that participate in the American College of Surgeons National Surgical Quality Improvement Program.
  
  
  METHODS
  Women undergoing laparoscopic hysterectomy between 2006 and 2010.
  
  
  METHODS
  Of 8846 patients, 3564 underwent treatment as outpatients, as defined by hospital billing.
  
  
  RESULTS
  Overall morbidity was low in both cohorts; however, significantly fewer 30-day complications were observed in outpatients (4.5%) than inpatients (7.2%) (p < .001). Individual medical and wound complications were also rare and were less common in outpatients whenever a significant difference existed. After adjusting for demographic and operative variables, multivariate regression models found outpatients to be at significantly lower risk for overall perioperative morbidity (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.53-0.78). Outpatients were less likely to experience wound complications (OR, 0.63; 95% CI, 0.46-0.87) and were at lower risk of medical complications (adjusted OR, 0.61; 95% CI, 0.49-0.77) and deep vein thrombosis (adjusted odds ratio, 0.61; 95% CI, 0.47-0.80). Outpatient designation was not a significant predictor for repeat operation (p = .09).
  
  
  CONCLUSIONS
  Outpatient laparoscopic hysterectomy procedures are not associated with increased risk of 30-day postoperative complications.
authors.affiliation: Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Nima
authors.initials: N
authors.lastname: Khavanin
authors.forename: Alexei
authors.initials: A
authors.lastname: Mlodinow
authors.forename: Magdy P
authors.initials: MP
authors.lastname: Milad
authors.forename: Karl Y
authors.initials: KY
authors.lastname: Bilimoria
authors.forename: John Y S
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007297:Inpatients; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007902:Length of Stay; D008875:Middle Aged; D010045:Outpatients; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome