Understanding Patient Interest and Preferences for Same-Day Discharge after Minimally Invasive Hysterectomy

Objective: This study was conducted to assess patient interest in same-day discharge and to understand factors associated with these patient preferences. Materials and Methods: This was a prospective observational study of women undergoing minimally invasive hysterectomy for benign or oncologic indications. Participants completed a survey assessing interest in same-day discharge preoperatively, 4-6 hours postoperatively, and on postoperative day 1. Demographics and perioperative parameters were abstracted from the electronic medical records. Univariable exact logistic regression models were used to estimate the odds of desiring same-day discharge. Results: Ninety-two patients were enrolled. The mean age was 47.9 years (standard deviation = 10). Most patients underwent laparoscopic or robotic hysterectomy (n = 77/92, 84%). Preoperatively, 65% (n = 60/92) of patients expressed interest in same-day discharge. Patients meeting discharge milestones were 4.24 (95% confidence interval [CI]: 1.10-24.43; exact p = 0.03) times more likely to desire same-day discharge. Conversely, patients expecting to stay at least 1 night were 0.12 (95% CI: 0.01-0.72; exact p = 0.02) times as likely to desire same-day discharge. Age, surgical route, indication, surgery duration, start time, and time of postoperative evaluation were not associated with interest in same-day discharge (all exact p > 0.05). The most-common reason for desiring overnight admission was pain control (n = 33/64, 52%). Conclusions: Preoperatively, most patients expressed interest in same-day discharge. Postoperatively, patients meeting discharge criteria and expecting discharge on the day of surgery were more likely to be interested in same-day discharge. Optimizing preoperative hysterectomy counseling would likely promote patient desire for same-day discharge.