OUTPATIENT HYSTERECTOMY - DETERMINANTS OF DISCHARGE AND REHOSPITALIZATION IN 133 PATIENTS

OBJECTIVE: This study examines our continuing experience in performing vaginal hysterectomies and laparoscopy-assisted vaginal hysterectomie s with an outpatient protocol. The purpose was to review factors assoc iated with discharge and hospitalization. STUDY DESIGN: Surgical recor ds from all women entering our previously reported outpatient hysterec tomy protocol were reviewed. Demographics, surgical indications, intra operative data, and postoperative data were studied, and their associa tions with patient discharge and hospitalization were determined. Spec ific attention was directed to complications. RESULTS: The study group consisted of 133 women. Twelve women (9.0%) were not discharged from the hospital and 5 (3.8%) required readmission. Surgical indications, the type of hysterectomy, and the requirement for pain medication reve aled no association with hospitalization. The occurrence of an intraop erative complication (p < 0.000), the need for transfusion (p = 0.043) , and postoperative antiemetics (p = 0.013) were statistically associa ted with hospitalization. In addition, low hematocrit values and eleva ted temperatures on the first and second postoperative days were assoc iated with hospitalization. CONCLUSION: Long-term experience with outp atient hysterectomy reveals a hospitalization rate of 12.8%. Complicat ions, blood loss, elevated temperatures, and postoperative nausea are the major determinants of patient discharge and hospitalization. Readm ission rates continue to remain low.