Thirty-day healthcare encounters after elective uterine artery embolization for fibroids with and without superior hypogastric nerve block

Abstract

To evaluate how the implementation of superior hypogastric nerve block (SHNB) during uterine artery embolization (UAE) for uterine fibroids impacts same-day discharge and healthcare encounters (HE) within 30 days. 240 patients who underwent successful UAE for fibroids between January 2018 and December 2022 were retrospectively reviewed. HE within 30 days, including emergency department (ED) and urgent care visits, admissions, and readmissions, were categorized as early (0-7 days of discharge) and late (8-30 days of discharge), and related or unrelated to interventional radiology (IR) care. Factors associated with same-day discharge and HE were identified with univariate analyses. Rates of HE based on SHNB status were compared using chi-square tests. Mean age was 46 ± 5 years; 125 patients received UAE with SHNB. Patients who underwent SHNB were significantly more likely to undergo same-day discharge (113/125, 90%) compared to those without SHNB (55/115, 48%) (p<0.001). There were no factors associated with rates of all-cause 30-day HE, including SHNB status (SHNB 17% (21/125) vs no SHNB 10% (12/115), p=0.20). A majority of HE were due to an IR-related cause (26/33, 79%), including abdominal or pelvic pain (22/33, 67%), nausea, vomiting, or poor oral intake (18/33, 55%), and vaginal bleeding (4/33, 12%). Comparing SHNB to no SHNB patients, there was no difference in the proportion of IR-related HE (17/21 (81%) vs 9/12 (75%), p=0.69). UAE with SHNB is associated with significantly higher rates of same-day discharge but similar rates of 30-day healthcare encounters, compared to UAE alone.