دورية أكاديمية
Trends and Perioperative Outcomes across Elective Benign Hysterectomy Procedures from the ACS-NSQIP 2007-2017.
| العنوان: | Trends and Perioperative Outcomes across Elective Benign Hysterectomy Procedures from the ACS-NSQIP 2007-2017. |
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| المؤلفون: | Tyan P; Capital Women's Care (Drs. Tyan and Hawa), Leesburg, Virginia. Electronic address: paultyan1@gmail.com., Hawa N; Capital Women's Care (Drs. Tyan and Hawa), Leesburg, Virginia., Carey E; Division of Minimally Invasive Gynecologic Surgery, University of North Carolina Chapel Hill (Dr. Carey), Chapel Hill, North Carolina., Urbina P; Department of Obstetrics and Gynecology (Dr. Urbina)., Chen FR; Department of Anesthesiology, Hospital of the University of Pennsylvania (Dr. Chen), Philadelphia, Pennsylvania., Sparks A; Department of Surgery (Dr. Amdur and Mr. Sparks)., Amdur R; Department of Surgery (Dr. Amdur and Mr. Sparks)., Moawad G; Division of Minimally Invasive Gynecologic Surgery (Dr. Moawad), George Washington University Health Science Center, Washington, District of Columbia. |
| المصدر: | Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2022 Mar; Vol. 29 (3), pp. 365-374.e2. Date of Electronic Publication: 2021 Oct 02. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101235322 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1553-4669 (Electronic) Linking ISSN: 15534650 NLM ISO Abbreviation: J Minim Invasive Gynecol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : Elsevier, c2005- |
| مواضيع طبية MeSH: | Laparoscopy*/methods , Postoperative Complications*/epidemiology, Cohort Studies ; Female ; Humans ; Hysterectomy/methods ; Hysterectomy, Vaginal ; Retrospective Studies |
| مستخلص: | Study Objective: In this study, we describe trends of all 3 routes of hysterectomy, patient demographics, and perioperative morbidity among women undergoing surgery for benign indications between 2007 and 2017. We also sought to compare the rates of extended length of stay (ELOS) and readmission rates among the laparoscopic, abdominal, and transvaginal routes. Study Design: A retrospective cohort study. Study Setting: National database study. Patients: The American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent an elective hysterectomy for benign indication between 2007 and 2017. Interventions: Patients were identified using Current Procedural Terminology codes and excluded if their indication for surgery included cancer and pelvic organ prolapse diagnoses based on International Classification of Diseases codes. The collected variables of interest included age, body mass index, American Society of Anesthesiologists classification, uterine weight of >250 grams, and operative time. Our outcomes of interest included ELOS and readmission within 30 days. ELOS was defined as a hospital admission of 2 days or more after laparoscopic and transvaginal hysterectomy and greater than 3 days for an abdominal hysterectomy. Summary statistics were used to evaluate shifts in patient characteristics and postoperative outcomes by hysterectomy route and year of surgery. Multivariable logistic regression analysis, stratified by year, comparing laparoscopic with transvaginal and abdominal hysterectomies was performed. Measurements and Main Results: There were 224 357 patients who met the inclusion and exclusion criteria. Of those, 132 567 (59.1%) underwent a laparoscopic hysterectomy, 30 105 (13.4%) a vaginal hysterectomy, and 61 685 (27.5%) an abdominal hysterectomy. The rate of laparoscopic hysterectomy increased by >200% between 2007 and 2017, whereas the rates of transvaginal and abdominal hysterectomies steadily decreased (-58% and -42%, respectively) The mean age, median obesity, and American Society of Anesthesiologists classification increased among women undergoing hysterectomy across all routes with the sharpest increase within the laparoscopic hysterectomy group (% increase in mean age [2.1%, 1.3%, 0.7%] and mean body mass index [9.1%, 4.3%, 3.7%] for laparoscopic, transvaginal, and abdominal routes, respectively). In 2017, the odds of ELOS were 29% lower for those who received laparoscopic than those who received abdominal hysterectomy (p <.001). Comparing the rates of readmission between the laparoscopic and abdominal hysterectomy groups shows that the odds of readmission are significantly lower for patients who receive a laparoscopic hysterectomy across all 11 years (p <.001). Conclusion: The rates of laparoscopic hysterectomy have been steadily increasing over the past 11 years. This large retrospective study confirms the lowest rates of readmission and ELOS within the laparoscopic hysterectomy group despite the rising medical complexity of the patients. (Copyright © 2021 AAGL. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Complications; Over time; Surgical volume |
| تواريخ الأحداث: | Date Created: 20211005 Date Completed: 20220328 Latest Revision: 20220401 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.jmig.2021.09.714 |
| PMID: | 34610464 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1553-4669 |
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| DOI: | 10.1016/j.jmig.2021.09.714 |