Microvascular decompression (MVD) has grown as a first-line surgical intervention for severe facial pain from trigeminal neuralgia and/or hemifacial spasm. We sought to examine the safety and cost-benefits of discharging MVD patients within one day of admission.We retrospectively reviewed patients undergoing MVD at our institution from 2008-2020. Patients were sorted by 1-day, 2-day, or >2-day days until discharge and by year from 2008-2013, 2014-2018, or 2019-2020. Patient presenting characteristics, intraoperative measures, and complications were documented. Statistical differences were calculated by one-way ANOVA and Chi-squared analyses.Our cohort included 976 patients undergoing MVD with 231 (23.6%) between 2008-2013, 517 (52.9%) between 2014-2018, and 228 (23.3%) between 2019-2020. Over time, postoperative admission rates to the critical care unit, total inpatient hospital admission times, and Barrow Neurological Institute (BNI) scores at first follow-up decreased. Postoperative complications, including CSF leak, decreased significantly. Additionally, patients discharged within one day of admission incurred a total hospital cost of $26,689, which was $3,588 lower than patients discharged within more than one day of admission, p<0.0001. Discharging carefully selected patients who are appropriate for discharge within one day of admission could translate to a potential cost-savings of $255,346 per year in our clinical practice.In our experience, microvascular decompressions are a safe, elective intervention. Our findings suggest that postoperative day one discharge in patients with an uncomplicated postoperative course may be safe while improving hospital resource utilization.
View details for DOI 10.1016/j.wneu.2022.07.037
View details for PubMedID 35842175