Ir J Med Sci. 2026 Jul 9. doi: 10.1007/s11845-026-04547-0. Online ahead of print.
ABSTRACT
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.
PMID:42423912 | DOI:10.1007/s11845-026-04547-0
