P9: Comparing Patient Reported Outcomes for Same-day Discharge and Inpatient Admission After Mastectomy

Friday, March 24, 2023

12:31 PM – 12:36 PM

Location: SSO HUB: Breast & Endocrine Zone

Poster Presenter(s)

Sudheer Vemuru, MD

Resident
University of Colorado Anschutz Medical Center
Aurora, Colorado, United States

Disclosure information not submitted.

Author(s)

KC

Kathryn L. Colborn, PhD, MSPH

Associate Professor
University of Colorado Anschutz Medical Campus, United States

Disclosure information not submitted.
LL

Laura D. Leonard, MD

Resident
University of Colorado School of Medicine, Department of Surgery, United States

Disclosure information not submitted.
VH

Victoria Huynh, MD

Resident
University of Colorado School of Medicine, Department of Surgery, United States

Disclosure information not submitted.
CK

Christodoulos Kaoutzanis, MD

Assistant Professor
University of Colorado School of Medicine, Department of Surgery, United States

Disclosure information not submitted.
JC

Justin Cohen, MD

Assistant Professor
University of Colorado School of Medicine, Department of Surgery, United States

Disclosure information not submitted.
DM

David Mathes, MD

Professor
Department of Surgery, University of Colorado Anschutz Medical Campus, United States

Disclosure information not submitted.
NC

Nicole Christian, MD

Assistant Professor
Department of Surgery, University of Colorado Anschutz Medical Campus, United States

Disclosure information not submitted.
GA

Gretchen Ahrendt, MD

Professor
Department of Surgery, University of Colorado Anschutz Medical Campus, United States

Disclosure information not submitted.
CF

Christine Fisher, MD

Professor
University of Colorado School of Medicine, Department of Radiology, United States

Disclosure information not submitted.
SK

Simon Kim, MD, MPH

Associate Professor
University of Colorado School of Medicine, Department of Surgery, United States

Disclosure information not submitted.
ST

Sarah Tevis, MD

Assistant Professor
Department of Surgery, University of Colorado Anschutz Medical Campus, United States

Disclosure information not submitted.

Introduction: Same-day discharge after mastectomy has been demonstrated to be safe in appropriately selected candidates. However, the impact of same-day discharge after mastectomy on patient reported outcomes (PROs) is unclear. In this study, we aimed to evaluate the effect of same-day discharge after mastectomy on PROs.

Methods: We performed a retrospective review of a longitudinal PRO registry of female breast cancer patients who underwent mastectomy at an academic breast center between June 2019 and June 2022. Patients were invited to complete the BREAST-Q module, a validated PRO scale measuring domains such as psychosocial wellbeing (PSW), physical wellbeing (PHW), satisfaction with their surgeon, and satisfaction with their medical team. Preoperative and 2-week postoperative questionnaire responses were analyzed. Patients were divided into two groups: those discharged on the date of surgery and those admitted to the hospital. The primary endpoints were mean satisfaction scores as well as differences between postoperative and preoperative PSW and PHW scores. T-tests were used to evaluate differences between groups. A multiple regression model was fit to adjust for the effects of relevant clinical and demographic factors.

Results: Of the 105 eligible patients, 59 completed both the preoperative and postoperative questionnaires (56% response rate); 21 (36%) in the same-day discharge group and 38 (64%) in the inpatient admission group. The groups were similar in age, stage, perioperative risk classification, body mass index, unplanned reoperations, and receipt of bilateral mastectomy, axillary lymph node dissection, post-mastectomy reconstruction, and neoadjuvant chemotherapy. Mean patient satisfaction scores and changes in PSW and PHW scores were similar between the groups at 2 weeks after surgery (Table 1). After controlling for age, reconstructive operation, receipt of unplanned reoperation, and preoperative scores, same-day discharge did not have a significant effect on satisfaction with the surgeon (Beta=-2.6, p=0.57), satisfaction with the medical team (Beta=0.6, p=0.87), PSW (Beta=7.1, p=0.22), or PHW (Beta=-0.4, p=0.95).

Conclusions: Patients discharged on the date of a mastectomy display similar levels of satisfaction with their care team and similar short-term trends in PSW and PHW compared to those admitted to the hospital. While further data are being accrued, these early results suggest patients tolerate same-day discharge after mastectomy well.

Learning Objectives:

Upon completion, participant will be able to define patient-reported outcomes.
Upon completion, participant will be able to describe how same-day discharge after mastectomy impacts physical and psychosocial wellbeing and physical wellbeing.
Upon completion, participant will be able to recount overall patient satisfaction with their surgeon and medical team among those discharged on the date of mastectomy.