LAUSR

30 Characteristics associated with prolonged length of stay after myomectomy for uterine fibroids C. G. Smith, D. Sharma, D. Davenport, M. R. Hoffman Obstetrics & Gynecology, University of Kentucky, Lexington, KY, Department of Surgery, University of Kentucky, Lexington, KY, Division of Gynecologic Subspecialties, Department of Obstetrics & Gynecology, University of Kentucky, Lexington, KY OBJECTIVES: The primary objective was to identify factors contributing to prolonged hospitalization for women undergoing myomectomy for uterine fibroids. MATERIALS AND METHODS: Retrospective population-based analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database identifying women from 2014-2016 undergoing myomectomy for uterine fibroids. Primary outcome was LOS > the median. Preoperative, intraoperative, and postoperative variables were examined to determine predictors for prolonged LOS. RESULTS: A total of 8042 women underwent myomectomies for uterine fibroids. The median LOS for all surgical approaches was 1 day. Non-white race, preoperative hematocrit < 38% (OR1⁄4 1.30, CI 1⁄4 1.19-1.43), preoperative blood transfusion (OR 2.82, CI 1⁄4 1.804.40), preoperative SIRS/sepsis (OR 6.27, CI 1⁄4 2.36-16.67), WBC count 4500/mm (OR 1⁄4 1.18, CI 1⁄4 1.03-1.35), perioperative blood transfusion (OR 5.93, CI 1⁄4 4.38-8.03), removal of numerous bulky fibroids (OR 1⁄4 1.49, CI 1⁄4 1.29-1.72), and operative time (OR1⁄4 1.25-1.64, CI 1⁄4 1.03-2.77) predicted prolonged LOS. Minimally invasive surgical (MIS) techniques protected against prolonged LOS (laparoscopic [OR 1⁄4 0.11, CI 1⁄4 0.09-0.13], vaginal [OR 1⁄4 0.18, CI 1⁄4 0.13-0.26]). CONCLUSION: Limited potentially modifiable perioperative factors contribute to prolonged LOS for myomectomy were identified and suggest areas for targeted interventions.