SIR 2024
Women's Health
Muhammad Mohid Tahir, MD (he/him/his)
Postdoctoral Research Fellow
Beth Israel Deaconess Medical Center
Disclosure information not submitted.
Julie C. Bulman, MD
Interventional Radiologist
Beth Israel Deaconess Medical Center, Harvard Medical School
Financial relationships: Full list of relationships is listed on the CME information page.
Ammar Sarwar, MD, FSIR (he/him/his)
Associate Professor of Radiology
Harvard Medical School / Beth Israel Deaconess Medical Center
Financial relationships: Full list of relationships is listed on the CME information page.
Superior hypogastric nerve block (SHNB) for pain control after uterine artery embolization (UAE) is associated with decreased opioid requirements but its effect on same-day discharges and readmissions is not well explored. This study aimed to determine the effect of SHNB on same-day discharge and readmission rates after elective UAE.
Materials and Methods:
We retrospectively reviewed 246 female patients (age: 46±5 years) who underwent elective UAE for fibroids or adenomyosis at a large urban tertiary academic center between January 2018 and December 2022. Same-day discharge, 7- and 30-day readmissions, and time to readmission were compared for patients receiving SHNB versus no SHNB using z-tests and t-tests. Readmission times were stratified by disposition status (same-day discharge vs post-procedure direct admission with subsequent readmission) to account for differences in post-procedural management.
Results:
Of 246 total cases, 125 (51%) included SHNB, and 173 (70%) were same-day discharges. Patients who received SHNB underwent same-day discharge at a higher rate than those who did not receive SHNB (90% vs 50%, p< .001). The overall rates for 7- and 30-day readmissions were 9% and 13%, respectively. Readmission rates among SHNB patients were 11% and 17%, respectively; rates among no SHNB patients were 7% and 9%, respectively. Comparing SHNB to no SHNB patients, there were no differences in 7- or 30-day readmissions among same-day discharges (12% vs 8%, p=.52; 18 vs 10%, p=.18, respectively), and among post-procedure admits (8% vs 5%, p=.63; 8% vs 8%, p=.98). Among patients readmitted within 30 days, the mean time to readmission was 6.9 days. Among same-day discharges, there was no difference in mean time to readmission between SHNB and no SHNB patients (6.8 vs 8.6 days, p=.68); this difference was not calculated among post-procedure admits due to low event rate.
Conclusion:
Patients receiving SHNB had more same-day discharges without increased readmission rates or time to readmission following elective UAE.