Predictors of 30‐day morbidity after hysterectomy for benign disease

• Published in: International journal of gynecology and obstetrics 2019-03, Vol.144 (3), p.302-308
• Main Authors: Shim, Seung‐Hyuk, Suh, Jung‐Hwa, Park, Ji‐Eun, Lee, Sun‐Joo, Lee, Ji‐Young, Kim, Soo‐Nyung, Kang, Soon‐Beom
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Gynecological surgery; Humans; Hysterectomy; Hysterectomy - adverse effects; Hysterectomy - statistics & numerical data; Hysterectomy, Vaginal - adverse effects; Hysterectomy, Vaginal - statistics & numerical data; Middle Aged; Postoperative complications; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Propensity Score; Republic of Korea - epidemiology; Retrospective Studies; Risk factors
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.12752

Objective To determine the 30‐day morbidity rate after hysterectomy for benign disease and identify predictors of 30‐day morbidity. Methods A retrospective study was conducted among women undergoing hysterectomy for benign indications between January 1, 2010, and December 31, 2015, at Konkuk University Hospital, South Korea. Multivariable regression analysis identified independent factors for morbidity. Results 1609 women were included. 30‐day morbidity rates were 4.5% (n=72) for the whole cohort: 7.5% (28/371), 3.2% (22/686), and 4.0% (22/552) for abdominal hysterectomy, laparoscopic‐assisted vaginal hysterectomy (LAVH), and vaginal hysterectomy, respectively. The most common 30‐day postoperative morbidities were urinary complications (1.2%, 20/1609), wound infection (0.9%, 14/1609), and blood transfusion more than 4 units (0.7%, 11/1609). In multivariate regression analysis, Charlson comorbidity index of 2 or more, operative time, and estimated blood loss were independently associated with morbidity. Propensity score‐matching indicated no difference in morbidity rates for the abdominal hysterectomy and LAVH or vaginal hysterectomy groups (P=0.351), whereas the LAVH or vaginal hysterectomy groups were more strongly associated with operation time, estimated blood loss, and length of postoperative hospital stay. Conclusion Comorbidity index, operative time, and blood loss were independently associated with morbidity following hysterectomy. These findings supported the preoperative optimization of comorbidities and the appropriate selection of surgical approaches. Comorbidity index, operative time, and blood loss are independently associated with morbidity following hysterectomy.