Same-day Discharge for Cleft Palate Repair: A Single-Surgeon Retrospective Analysis

Abstract

Objective

To evaluate the safety of same-day discharge for patients undergoing primary cleft palate repair

Design

Single-surgeon retrospective review

Setting

Tertiary care institution

Patients/Participants

40 consecutive patients that underwent primary cleft palate repair by a single surgeon from September 2018 to June 2023

Interventions

Same-day discharge versus overnight admission after primary palatoplasty

Main Outcome Measures

30-day readmission, reoperation, wound and all-cause complication rate and 1-year fistula incidence

Results

Of 40 total cases, 20 patients were discharged on the same calendar day and 20 patients were admitted for overnight stay following primary cleft palate repair. In the same-day discharge group, readmission incidence was 10%(n = 2), wound complication incidence was 5%(n = 1), and postoperative complication incidence was 15%(n = 3). In comparison, patients admitted overnight had a readmission incidence of 5%(n = 1, P = 1.00), wound complication incidence of 10%(n = 2, P = 1.00), and postoperative complications of 20%(n = 4, P = 1.00) No patients had 30-day reoperations or fistulas at 1 year. A higher proportion of admitted patients held a preoperative diagnosis of unilateral cleft palate and alveolus (Veau 3) as compared to patients discharged on the same day (P = .019). During the postoperative hospital course, admitted patients received significantly more oxycodone at median of 2 doses (IQR 1.00–3.75) and acetaminophen at a median of 4 doses (IQR 3.00–5.00) than patients with same-day discharge with a median of 1 dose (IQR 0.00 –1.00, P < .001).

Conclusions

In a low-risk patient population, same-day discharge following primary cleft palate repair may be safely undertaken and result in similar short-term outcomes and 1-year fistula incidence as patients admitted for overnight stay.