Same-day Discharge for Cleft Palate Repair: A Single-Surgeon Retrospective Analysis.

Abstract

Objective: To evaluate the safety of same-day discharge for patients undergoing primary cleft palate repair.

Design: Single-surgeon retrospective review.

Setting: Tertiary care institution.

Patients/participants: 40 consecutive patients that underwent primary cleft palate repair by a single surgeon from September 2018 to June 2023.

Interventions: Same-day discharge versus overnight admission after primary palatoplasty.

Main outcome measures: 30-day readmission, reoperation, wound and all-cause complication rate and 1-year fistula incidence.

Results: Of 40 total cases, 20 patients were discharged on the same calendar day and 20 patients were admitted for overnight stay following primary cleft palate repair. In the same-day discharge group, readmission incidence was 10%(n = 2), wound complication incidence was 5%(n = 1), and postoperative complication incidence was 15%(n = 3). In comparison, patients admitted overnight had a readmission incidence of 5%(n = 1, P = 1.00), wound complication incidence of 10%(n = 2, P = 1.00), and postoperative complications of 20%(n = 4, P = 1.00) No patients had 30-day reoperations or fistulas at 1 year. A higher proportion of admitted patients held a preoperative diagnosis of unilateral cleft palate and alveolus (Veau 3) as compared to patients discharged on the same day (P = .019). During the postoperative hospital course, admitted patients received significantly more oxycodone at median of 2 doses (IQR 1.00-3.75) and acetaminophen at a median of 4 doses (IQR 3.00-5.00) than patients with same-day discharge with a median of 1 dose (IQR 0.00 -1.00, P < .001).

Conclusions: In a low-risk patient population, same-day discharge following primary cleft palate repair may be safely undertaken and result in similar short-term outcomes and 1-year fistula incidence as patients admitted for overnight stay.