1346 Optimizing Outpatient Neurosurgery: Evaluating Same-Day Discharge Following Cranial Surgery

INTRODUCTION: Outpatient surgery and same-day discharge meet the changing demands of modern healthcare, offering advantages like lower infection risks and medical errors. Enhanced Recovery After Surgery (ERAS) protocols further enhance these benefits, potentially enabling safe outpatient cranial surgeries. METHODS: A retrospective analysis of patients scheduled for planned SDD after cranial surgery between August 2020 and October 2023 was conducted. Data included patient demographics, preoperative clinical deficits, diagnosis, pre-and postoperative magnetic resonance imaging (MRI) scans, lesion characteristics, complications, and readmission rates. RESULTS: A total of 202 patients were included in the study. The mean age was 56.8 years with 117 (57.9%) of them being female. The surgeries performed were either awake craniotomies for 491 individuals or craniotomies conducted under general anesthesia for 139 patients. Complications occurred in 1.5% of patients, with no permanent complications observed during a mean follow-up of 9.3 months. 179 patients (88.6%) were successfully discharged on the same day as planned. The mean length of hospitalization was 27.5 hours, with the mean length of postoperative stay being 8.6 hours. Twenty-three (11.4%) patients deemed ineligible for same-day discharge and instead discharged on postoperative day 1. Reasons for these delays included further clinical monitoring (n=12), social factors (n=4), and patient preference (n=7). Age positively correlated with length of hospitalization (p=0.006). 6.4% of patients readmitted within 1-30 days post-discharge, 5 of them (2.5%) readmitted to neurosurgery. CONCLUSIONS: This study demonstrates the safety and feasibility of same-day discharge following cranial surgery, with a high success rate and low complication rates. Early discharge did not increase morbidity or readmission rates. Implementation of clear discharge protocols and thorough patient education are crucial for successful same-day discharge programs in neurosurgery.