Abstract
Discussion Forum (0)
Introduction: The objective of this study is to investigate the impact of uterine weight on peri-operative hysterectomy outcomes. Risk stratification based on uterine weight may help guide surgical planning and post-operative management.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
Introduction: The objective of this study is to investigate the impact of uterine weight on peri-operative hysterectomy outcomes. Risk stratification based on uterine weight may help guide surgical planning and post-operative management.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
Uterine weight as a predictor of surgical complications
Dr. Jinhee Oh
Affiliations:
Pennsylvania Hospital/Penn Medicine/University of Pennsylvania
Pennsylvania Hospital/Penn Medicine/University of Pennsylvania
Abstract
Discussion Forum (0)
Introduction: The objective of this study is to investigate the impact of uterine weight on peri-operative hysterectomy outcomes. Risk stratification based on uterine weight may help guide surgical planning and post-operative management.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
Introduction: The objective of this study is to investigate the impact of uterine weight on peri-operative hysterectomy outcomes. Risk stratification based on uterine weight may help guide surgical planning and post-operative management.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
Methods: Hysterectomy patients were identified from the NSQIP Database (2014 – 2017). Uterine weight was evaluated as a categorical variable: Group A (less than or equal to 250 g), Group B (greater than 250 g to less than or equal to 500 g), Group C (greater than 500 g). Univariable and multivariable statistics were performed. IRB approval was waived.
Results: 50,333 patients were included, 82.6% in Group A (n=41,581), 12.7% in Group B (n=6,369), and 4.7% in Group C (n=2,383). The majority of the patients were White (71.5%). Median age and BMI were 48 (IQR 42, 59) and 30.5 (IQR 25.7, 36.8). There was an association between race and the proportion of patients in Group C: White 3.3%, AA 11.6%, Asian 9.0%, Other 4.8% (p=0.000). Uterine weight was moderately correlated (R2=0.038) with operative time. Group B had nearly 3 times the likelihood of blood transfusion (OR 2.82, 95% CI: 2.34, 3.40). Likelihood increased to 4 times for Group C (OR 4.08, 95% CI: 3.22, 5.18). Group C was associated with increased conversion from MIS to open (OR 4.93, 95% CI: 1.91, 12.71). There was no association with LOS, infection, dehiscence, urinary injury, VTE, readmission/re-operation.
Conclusion/Implications: Increased uterine weight is associated with transfusion and conversion to open approach. Uterine weight may assist with pre-operative risk stratification and serve as a predictor of complications.
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