Patient's Opinion Regarding Same Day Discharge Following EVAR
Elias Fakhoury, Mollie O'Brien-Irr, Mark Asirwatham, Gregory Cherr, Hasan Dosluoglu, Maciej Dryjski, Linda Harris.
University at Buffalo, Buffalo, NY, USA.
OBJECTIVES: To evaluate patient opinion regarding potential same day discharge (SDD) following elective endovascular repair (EVAR) of abdominal aortic aneurysm
METHODS: This was an observational study at a tertiary care facility during a five-year period of elective EVAR of patients discharged postoperative day one (POD #1). Attempt to contact patients was made via telephone/mail survey to ascertain if they would favor SDD had their surgeon considered it appropriate. Analysis was by Chi Square
RESULTS: There were 288 elective EVAR; 216 were discharged POD #1. Eleven patients were deceased; surveys were completed by 71/205 (35%). There were no significant differences in preoperative characteristics of respondents vs. non-respondents. The mean age of respondents was 73 +9 years; 80% were male. Forty-nine (69%) preferred SDD, the most common reason being comfort 96%. There was no difference in preference for SDD on the basis of preoperative characteristics/comorbidities with the exception of COPD, (50% vs.79%; P= 0.025) Table I. Among those preferring hospitalization, reasons included: postoperative concerns 59%, anxiety about going home too soon 37%, other health concerns 9%, lack of transportation 5%, unavailability of a care provider 0%.
CONCLUSIONS: Most patients who undergo EVAR would favor SDD if deemed appropriate by their surgeon. Factors such as gender, older age, living and ambulatory status that intuitively might restrict SDD did not negatively influence choice for SDD. Among those preferring hospitalization, that decision was most often based upon perception rather than logistic issues that could deter SDD. This study provides corroborating evidence to petition regulating agencies to seek change in EVAR admission status and allow for SDD for appropriate patients without adverse financial impact to institutions or patients. 
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