eP142 - Early Discharge After Enhanced Recovery Rectal Resection Does Not Increase Emergency Department Visits and Readmissions: A Single Institution Analysis

Purpose/Background: Same-day discharge after colectomy in enhanced recovery pathways has been shown to be feasible and safe. It is not clear how early patients with rectal resections may be safely discharged. The aim of this study is to determine if patients with rectal resections discharge ≤3 days (POD-1-3) is associated with increased rates of ED visits and hospital readmissions.Methods/Interventions: This is a retrospective single institution analysis of data maintained prospectively in a colorectal surgery database (REDCap®) from 01/01/2018 through 07/15/2022. All enhanced recovery patients have clinic visits within 4-7 days after discharge, at 30-days, and every 1-2 weeks for stoma patients until no longer needed. Primary outcomes were ED visit and readmission rates following low anterior resection, abdominoperineal resection, and proctocolectomy with and without stomas. The association of discharge day with ED visits and readmissions was analyzed using logistic regressions models.Results/Outcomes: A total of 118 patients met inclusion criteria, 76 with stomas. Mean age was 58.6 years; 59.3% were ASA-3, and 69.5% had a minimally invasive surgical approach. Comorbidities, diagnosis (p=0.780) and stoma type (p=0.850) were not significantly different across discharge day groups. ED visits were not significantly different between discharge-day groups (p=0.096). No patients were discharged same-day, one without a stoma was discharged on POD-1, ten patients (2 with stomas) on POD-2, and twenty-four patients (13 with stomas) on POD-3. ED visits were lowest for the POD-1-3 group (14.3%) and not significantly different than later discharge groups (p=0.166). Readmission rate was also lowest for the POD-1-3 group (11.4%) and also not significantly different than later discharge groups (p=0.261) and confirmed with logistic regression. Complication rate was lowest in the POD-1-3 group (p < 0.001)Conclusion/

Discussion: Early discharge after enhanced recovery partial or complete proctectomy is not associated with increased ED visits and readmissions. Discharge on postoperative day 2 may be feasible for selected prepared patients including some with stomas.Emergency Department Visits and Readmissions