Analysis of sociodemographic factors affecting ambulatory surgical center discharge patterns for endometrial cancer hysterectomies

Authors

Stephanie M. Wang, George Washington University Hospital, Department of Obstetrics and Gynecology 900 23rd ST NW Washington, DC 20037. Electronic address: swang16@gwu.edu.
Catherine Moore, George Washington University Hospital, Department of Obstetrics and Gynecology 900 23rd ST NW Washington, DC 20037. Electronic address: catherinemoore@email.gwu.edu.
Emma Keegan, George Washington University, School of Medicine and Health Sciences 2300 I St NW Washington, DC 20052. Electronic address: emmakeegan@gwmail.gwu.edu.
Christopher Mayer, Cedars-Sinai Medical Center, Department of Obstetrics and Gynecology 8635 W 3rd St Los Angeles, CA 90048. Electronic address: christophermmayer@gmail.com.
Ethan Litman, George Washington University Hospital, Department of Obstetrics and Gynecology 900 23rd ST NW Washington, DC 20037. Electronic address: elitman@gwu.edu.
Kirsten Jh Das, George Washington University Hospital, Department of Obstetrics and Gynecology 900 23rd ST NW Washington, DC 20037. Electronic address: kjh@email.gwu.edu.
Catherine Z. Wu, Washington DC Veterans Affairs Medical Center, Department of Gynecology 50 Irving St NW Washington DC 20422. Electronic address: cat.wu.md@gmail.com.
Nicole P. Chappell, George Washington University Hospital, Department of Obstetrics and Gynecology 900 23rd ST NW Washington, DC 20037. Electronic address: nchappell@mfa.gwu.edu.

Document Type

Journal Article

Publication Date

7-24-2023

Journal

Journal of minimally invasive gynecology

DOI

10.1016/j.jmig.2023.07.010

Keywords

Ambulatory surgical center; Endometrial cancer; Minimally invasive hysterectomy; Same day surgery

Abstract

STUDY OBJECTIVE: Investigateoutcomes for patients undergoing minimally invasive hysterectomies (MIH) performed for endometrial cancer at ambulatory surgery centers (ASC). DESIGN: Our study aims to explore the feasibility and discharge outcomes for MIHs for endometrial cancer in an ASC setting by utilizing same-day discharge data. SETTING: The prevalence of MIH for endometrial cancer between 2016-2019 was estimated from the Nationwide Ambulatory Surgery Sample (NASS). PATIENTS: Patient who underwent MIHs for endometrial cancer at an ASC were included. INTERVENTIONS: N/A MEASUREMENTS: Weighted estimates of prevalence and association between discharge status and sociodemographic factors were explored. Same-day discharge was defined as discharge on day of surgery, and delayed discharge was defined as discharge after day of surgery. MAIN RESULTS: An estimated 95,041 MIH for endometrial cancer were performed at ASCs between 2016-2019. 91.9% (n= 87,372) resulted in same-day discharge, 1.2% (n=1,121) had delayed discharge, and 6.9% (n=6,548) had missing discharge information. 78.7% procedures (n=68,812) were performed at public hospitals. The proportion of delayed discharges were lower in private, not-for profit ASCs (0.8%, p=0.03) compared to public hospitals. Patients who had delayed discharges on average were older (69.7 vs. 62.4 years, p<.001), more likely to have co-morbid conditions including diabetes (aOR 1.48, 95% CI 1.25-1.75); overweight or obese BMIs (aOR 1.18, 95% CI 1.01-1.39), and more likely to have public insurance (aOR 1.78, 95% CI 1.40-2.25). CONCLUSION: MIHs for endometrial cancer are feasible in an ASC. Optimal candidates for receipt of MIHs for endometrial cancer at an ASC are patients who are younger, have less comorbidities, lower BMI, and private insurance.

APA Citation

Wang, Stephanie M.; Moore, Catherine; Keegan, Emma; Mayer, Christopher; Litman, Ethan; Das, Kirsten Jh; Wu, Catherine Z.; and Chappell, Nicole P., "Analysis of sociodemographic factors affecting ambulatory surgical center discharge patterns for endometrial cancer hysterectomies" (2023). GW Authored Works. Paper 3037.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3037

Department

Obstetrics and Gynecology