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Background <p>Standard postoperative care for major gynecologic and obstetric surgery traditionally involves a 48-hour observation period. However, extraordinary crises such as the COVID-19 pandemic and the 2023 Kahramanmaraş earthquake necessitated an accelerated 24-hour discharge protocol to preserve hospital capacity.</p> Aims <p>This study aims to evaluate whether a 24-hour early discharge protocol is non-inferior to the conventional 48-hour standard regarding clinical complications.</p> Methods <p>In this retrospective cohort study, data from 11,670 patients (2010–2024) were analyzed. Patients were categorized into Pandemic (<i>n</i> = 2,924) and Earthquake (<i>n</i> = 1,194) groups (24-hour discharge), and a Control group (<i>n</i> = 7,552; 48-hour discharge). Primary outcomes included surgical site infection (SSI), urinary tract infection (UTI), wound dehiscence, and hemorrhagic complications within 30 days.</p> Results <p>Non-inferiority was established for SSI (4.3% and 4.4% vs. 4.1%), UTI (3.5% and 3.6% vs. 3.3%), and wound dehiscence (1.4% and 1.3% vs. 1.3%). Multivariable regression confirmed that hospitalization duration was not an independent predictor of SSI (<i>p</i> &gt; 0.500), whereas obesity (OR: 1.91; <i>p</i> &lt; 0.001) was the primary risk factor. Hemorrhagic complication results remained inconclusive due to insufficient statistical power.</p> Conclusions <p>A 24-hour postoperative discharge protocol is non-inferior to the 48-hour standard for most major complications following benign surgery. These findings suggest that patient-intrinsic factors, specifically BMI, drive infection risk more than the length of hospital stay.</p>

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The safety profile of early postoperative discharge in gynecologic and obstetric surgery: a retrospective analysis of clinical outcomes of the 24-hour protocol

  • 期刊论文

  • 发表日期：

    2026年7月9日

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  • Hamza Yildiz,
  • Kasim Akay,
  • Bengisu Asut,
  • Huseyin Durukan,
  • Hakan Aytan,
  • Faik Gurkan Yazici

摘要

Background

Standard postoperative care for major gynecologic and obstetric surgery traditionally involves a 48-hour observation period. However, extraordinary crises such as the COVID-19 pandemic and the 2023 Kahramanmaraş earthquake necessitated an accelerated 24-hour discharge protocol to preserve hospital capacity.

Aims

This study aims to evaluate whether a 24-hour early discharge protocol is non-inferior to the conventional 48-hour standard regarding clinical complications.

Methods

In this retrospective cohort study, data from 11,670 patients (2010–2024) were analyzed. Patients were categorized into Pandemic (n = 2,924) and Earthquake (n = 1,194) groups (24-hour discharge), and a Control group (n = 7,552; 48-hour discharge). Primary outcomes included surgical site infection (SSI), urinary tract infection (UTI), wound dehiscence, and hemorrhagic complications within 30 days.

Results

Non-inferiority was established for SSI (4.3% and 4.4% vs. 4.1%), UTI (3.5% and 3.6% vs. 3.3%), and wound dehiscence (1.4% and 1.3% vs. 1.3%). Multivariable regression confirmed that hospitalization duration was not an independent predictor of SSI (p > 0.500), whereas obesity (OR: 1.91; p < 0.001) was the primary risk factor. Hemorrhagic complication results remained inconclusive due to insufficient statistical power.

Conclusions

A 24-hour postoperative discharge protocol is non-inferior to the 48-hour standard for most major complications following benign surgery. These findings suggest that patient-intrinsic factors, specifically BMI, drive infection risk more than the length of hospital stay.