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

Document Type

Journal Article

Publication Date



Journal of minimally invasive gynecology




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


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.


Obstetrics and Gynecology