Abstract

Purpose: To compare the safety of and patient satisfaction with same-day discharge versus overnight stay after uterine artery embolization (UAE) for patients with symptomatic uterine fibroids Materials and Methods: A prospective observational study of patients who underwent UAE for symptomatic fibroids from January 2018 to June 2020 was performed. Chart review was performed for outcomes of interest including complication rates, readmission rates, emergency department visits, and inpatient narcotic usage. During post-procedure follow-up, patients completed an optional survey to measure self-reported post-procedural pain scores and satisfaction with pain regimen, length of hospital stay, and overall satisfaction. Results: Of 49 UAEs performed during the study period, 29% (n = 14) of patients were discharged home the same day and 71% (n = 35) were admitted for an overnight stay. When comparing the same-day discharge to overnight stay groups, no significant difference was found in complication rates (7% vs 26%, P = 0.24), emergency department visits (0% vs 14%, P = 0.30), re-hospitalization (0% vs 6%, P = 1), or opioid use (mean of 17 vs 26 morphine equivalents, P = 0.85). The survey received 18 responses, of which 33% (n = 6) were discharged home the same day and 67% (n = 12) were admitted overnight. When comparing the same-day discharge to overnight stay groups, no significant difference was found between self-reported pain the night of the procedure (on a scale from 0 to 10, mean 7 vs 5.5, P = 0.31), self-reported pain the week after the procedure (mean 4.9 vs 3.2, P = 0.23), satisfaction with the pain regimen (P = 0.7), satisfaction with the outpatient pain regimen (P = 0.28), satisfaction with length of hospital stay (P = 0.17), and overall satisfaction (P = 0.89). Conclusions: Same-day discharge after UAE when compared to overnight stay was found to have no significant difference in rates of readmission, emergency room visits, narcotic usage, patient-reported post-procedural pain, satisfaction with inpatient and outpatient pain regimen, satisfaction with length of hospital stay, and overall patient satisfaction. Same-day discharge is a safe and feasible option for patients undergoing UAE which may provide improved cost-effectiveness and resource utilization benefits for both the patient and the healthcare system. In light of the ongoing COVID-19 pandemic, prioritization of resource allocation without compromise of patient safety will be of utmost importance.

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