Next-day discharge after minimally invasive partial nephrectomy: an analysis of the US National Surgical Quality Improvement Program.

Journal Article (Journal Article)

Purpose

Clinical care pathways and new technologies have decreased the length of stay after many surgeries. However, doubt exists about the safety of shorter hospital stays. We sought to evaluate the feasibility of next-day discharge after minimally invasive partial nephrectomy in a national cohort of US patients and surgeons.

Methods

Using the National Surgical Quality Improvement Program database, we analyzed patients who underwent minimally invasive partial nephrectomy from 2012 to 2016. Patients were grouped into discharge on post-operative day 1, or discharge on days 2 and 3. Propensity score matching was used to balance patient characteristics and univariable analysis was used to determine the effect of next-day discharge on readmission, post-discharge complications, and major post-discharge complications.

Results

A total of 8153 patients were included in the analysis and 4430 were matched. The matched cohort was balanced on all patient and peri-operative characteristics. On univariable analysis, no increase in odds were observed in the next-day discharge group for readmission (odds ratio 0.8; 95% confidence interval 0.6-1.4; p = 0.2), post-discharge complications (odds ratio 1.0; 95% confidence interval 0.7-1.4; p = 0.9), or post-discharge major complications (odds ratio 0.9; 95% confidence interval 0.5-1.4; p = 0.6).

Conclusions

Next-day discharge in select patients after minimally invasive partial nephrectomy is effectively being utilized by a large, nationwide cohort of surgeons. This approach is feasible in certain patient populations though further research must determine selection criteria for safe next-day discharge.

Full Text

Duke Authors

Cited Authors

  • Berger, I; Xia, L; Sperling, C; Chelluri, R; Taylor, B; Pulido, J; Guzzo, TJ

Published Date

  • May 2019

Published In

Volume / Issue

  • 37 / 5

Start / End Page

  • 831 - 836

PubMed ID

  • 30159653

Pubmed Central ID

  • 30159653

Electronic International Standard Serial Number (EISSN)

  • 1433-8726

International Standard Serial Number (ISSN)

  • 0724-4983

Digital Object Identifier (DOI)

  • 10.1007/s00345-018-2469-2

Language

  • eng