Abstract No. 602 Discharge versus Overnight Observation: Trends in Post–Uterine Fibroid Embolization Management

The purpose of the following study is to characterize the rates of overnight observation of patients that received an outpatient uterine fibroid embolization (UFE) procedure. Claims for outpatient UFE instances were queried between 2009-2021 through the Merative MarketScan Commercial Claims and Encounters Database. Inpatient admissions were cross-referenced to identify patients who were admitted after UFE. A continuous enrollment period of 90 days before and after the outpatient procedure was implemented to ensure the accuracy of the observed time-interval. All patients admitted within one day of their outpatient UFE procedure were included as overnight observations. Any admission after one day was considered a readmission. Overnight observation ratios and readmission ratios were calculated for each year from 2009-2021. The length of stay for each overnight observation was determined using inpatient admission and discharge dates. Using inpatient ICD-9/10 diagnosis codes, Charlson Comorbidity Index (CCI) values were created for each patient and averaged across length of stay intervals. Between 2000-2021, 19,395 patients underwent UFE. 434 (2.2%) of total patients were admitted for overnight observation. Of these, 443 (99.8%) were included in the length of stay analysis. Table 602.1 shows the percentage of patients admitted for overnight observation and all readmissions for each year. Of the observation patients (n = 434), 5.3% were readmitted within 90 days (mean, 24.7 days). Of all patients discharged post procedure (n = 18,961), 3.1% were readmitted. Length of stay vs average CCI: 0d (n=23, 0.35), 1d (n=299, 0.11), 2d (n=76, 0.14), 3d (n=13, 0.15), 4d (n=9, 0.56), 5d (n=6, 0.67), 6-8d (n=5, 0.0), 9-12d (n=2, 3.0), 13+d (n=0). Our findings demonstrate a trend toward decreased overnight observations while post procedure readmission rates show no clear change. CCI of patients is positively correlated with length of stay. Among others, findings may reflect increased peri-procedural optimization or improved patient selection, which may support developing practices of UFE in the outpatient-based laboratory setting.