Fibroid burden does not affect the risk profile of same-day discharge after minimally invasive myomectomy: a comparison 011 post-operative complication rates by length of stay

To compare postoperative complication rates between same-day discharge (SDD) and admitted patients after minimally invasive myomectomy (MIM) based on fibroid burden. Demographics, perioperative variables, and 30-day postoperative complications were extracted from the National Surgical Quality Improvement Program database on patients undergoing MIM between 2015-2019, stratified by low fibroid burden (1-4 fibroids and ≤250 grams, CPT 58545) and high fibroid burden (>5 fibroids or >250 grams, CPT 58546). Chi Square, Fisher’s exact, univariable and multivariable logistic regression were performed. Of 8100 patients who underwent MIM, 5656 had a low fibroid burden and 2444 had a high fibroid burden. SDD rate was 64.6% of those with low fibroid burden and 56.8% for high fibroid burden. Overall rate of SDD rose from 57.2% in 2015 to 65.0% in 2019. Unadjusted postoperative complication rates are shown in Table 1. Age, race, ASA classification 3 or 4, pre-operative hematocrit <36%, hypertension, diabetes, bleeding disorder, and operative time were associated with admission. After adjusting for these variables, composite postoperative complication rates were similar between SDD and admission regardless of fibroid burden (adjusted OR 0.66; 95% CI 0.18-2.47 for low fibroid burden and aOR 0.91; 95% CI 0.18-4.63 for high fibroid burden). Odds of urinary tract infection was higher among admitted patients with low fibroid burden (aOR 4.6; 95% CI 1.13-18.72), and odds of blood transfusion was higher in admitted patients with both low (aOR 9.1; 95% CI 2.27-37.04) and high (aOR 8.24; 95% CI 1.59-42.49) fibroid burdens. The rate of SDD after MIM has increased over time. Though blood transfusions were more common among admitted patients, composite postoperative complication rates were similar between SDD and admitted cohorts regardless of fibroid burden.