Comorbidities May Predict Non-Home Discharge After Hysterectomy
Identifying patients at risk of non-home discharge can help discussions of recovery expectations and discharge planning.
Presence of comorbidities is associated with non-home discharge after hysterectomy for gynecologic malignancy, according to a study presented at the 48th Annual Meeting of the Society of Gynecologic Oncology.1
Identifying patients at risk of non-home discharge can aid in discussion of recovery expectations, early discharge planning, and hospital resource allocation. The purpose of this study was to develop a preoperative risk-scoring model to identify patients at high risk of non-home discharge after surgery for a gynecologic malignancy.
This retrospective cohort study evaluated data from 2134 women who underwent hysterectomy for gynecologic malignancy between January 2013 and April 2015. A nanogram was developed using a multivariable model.
In the study, 3.1% of the cohort was not discharged to home after undergoing hysterectomy, and there was no difference in non-home discharge rate between gynecologic tumor types. The most frequent non-home destination was skilled nursing facilities (68.2%) and inpatient rehabilitation (19.7%). Women with a non-home discharge were more likely to have a longer hospitalization compared with patients who were discharged to home (10 days vs 3 days; P <.0001).
Factors associated with a non-home discharge included comorbidities such as hypertension, diabetes, coronary artery disease, dyspnea, arrhythmia, and history of deep vein thrombosis and pulmonary embolism. Non-home discharge was significantly more likely in women with 1 risk factor (adjusted odds ratio [OR], 3.4; P =.03) or 2 or more risk factors (adjusted OR, 5.1; P =.003) compared with women with no risk factors.
Non-home discharge was also associated with undergoing laparotomy vs laparoscopy, and older age (70 years or older).
1. Penn CA, Kamdar NS, Morgan DM, et al. Preoperatively predicting non-home discharge after surgery for gynecologic malignancy. Presented at: 48th Annual Meeting of the Society of Gynecologic Oncology; March 12-15, 2017; National Harbor, MD.