CIO 2021-4 Is Same-Day Home Discharge Safe After Liver Microwave Ablation?: A Case Control Study

Purpose: To retrospectively evaluate the safety of same-day discharge in patients who underwent liver microwave ablation compared with those admitted for overnight observation.

Material and Methods: IRB approval was obtained. We reviewed patients presenting for hepatic microwave ablation for primary or metastatic lesions between 2017-2020. A total of 185 cases were included in this study. 22 cases discharged on the same day and 163 admitted for at least one day. 30-day outcomes included readmission rates, emergency department visits, delayed complications, and mortality. Immediate minor and major complications were also assessed.

Results: Baseline demographics in both groups were not significantly different (p >0.05). The multivariate logistic analysis showed a statistically significant (p < 0.05) difference in 30-day readmission rates, emergency visits, delayed complications, and mortality in favor of patients discharged the same day compared to those admitted for at least one night. No patients sent home on the same day were readmitted or presented to the ED within 30 days. The most prevalent immediate complications were pneumothorax and bleeding. The most common reasons for 30-day readmission or ED visit were symptomatic hydrothorax and ascites. One patient admitted overnight overdosed on PCA-pump requiring Narcan administration for reversal. Three patients admitted overnight died within 30-days.

Conclusions: Outpatients presenting for Liver microwave ablation can be safely discharged home on the same day if no immediate complications necessitate admission.