Trends in use of outpatient minimally-invasive adrenalectomy: A population-based analysis

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2025-02-13 DOI:10.1016/j.amjsurg.2025.116247

J. Walker Rosenthal , Caitlin B. Finn , Jasmine Hwang , James E. Sharpe , Shane T. Williams , Lauren N. Krumeich , Doug L. Fraker , Heather Wachtel , Rachel R. Kelz

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Abstract

Purpose

To examine temporal trends and outcomes of outpatient adrenalectomy in a population-based sample.

Methods

We performed a retrospective cohort study using the Healthcare Cost and Utilization Project's State Inpatient and State Ambulatory Surgery Databases, 2016–2020. Patients undergoing minimally invasive adrenalectomy were identified using billing codes. The primary exposure was admission status defined by length of stay. Outcomes included temporal trend in admission type, readmission rates and costs.

Results

Among 4431 adrenalectomies, 51.3 % were performed in the outpatient setting. The majority were observed overnight with only 100 patients (2.3 %) discharged same-day. Outpatient adrenalectomy increased annually from 44.1 % in 2016 to 59.2 % in 2020 (p < 0.01). Median costs were similar with a risk-adjusted marginal difference of $179 (same-day: $9565 vs overnight $9491; p = 0.81). Odds of readmission were similar between same-day and overnight stays (OR 0.18; p = 0.10).

Conclusion

Given similar costs and readmission rates, case selection and surgeon expertise should continue to guide decision-making on same-day adrenalectomy.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.