Article Text
Abstract
Introduction Age is a risk factor for post-operative complications. The current study compares outcomes of patients >= 70 years undergoing minimally invasive gynecology oncology surgery with same day discharge to those under the age of 70.
Methods The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was employed to identify all gynecology oncology cases from 2013 to 2021. Patients scheduled for outpatient minimally invasive surgery were included and separated according to a 70 years of age cutoff. The primary outcome was 30-day readmission rate. Secondary outcomes were timing and reasons for readmission, reoperation rate, and 30-day mortality. Chi square, Fisher, and Wilcox tests, and logistic regression were used to compare outcomes.
Results The study included 25 977 patients with a 3.1% readmission rate. There were 19469 patients (74.9%) under 70 and 6508 patients (25.1%) 70 years and older. The 30-day readmission rate was 2.9% in the younger and 3.9% in the older group (p<0.005), while the median number of days until readmission was 10 versus 8 respectively (p=0.06). Reasons for readmission did not differ between the groups (p>0.05). Patients over 70 were more likely to stay overnight or spend two nights or more in the hospital (p<0.05). Older patients also had higher rates of reoperation (1.2% vs 0.7%, p<0.005) and 30-day mortality (0.17% vs 0.0.5%, p<0.05).
Conclusion/Implications Older patients have higher rates of readmission, reoperation, and 30-day mortality. However, rates in both groups remain low and this difference is unlikely clinically meaningful.