Abstract
Objective: We sought to develop and evaluate a risk-adjusted perioperative morbidity model for vaginal hysterectomy. Study Design: Medical records of women who underwent vaginal hysterectomy during 2004 and 2005 were retrospectively reviewed. Morbidity included hospital readmission, reoperation, and unplanned medical intervention or intensive care unit admission; urinary tract infections were excluded. Multivariate logistic regression identified factors associated with perioperative morbidity (adjusted for urinary tract infection). The resulting model was validated using a random 2006 sample. Results: Of 712 patients, 139 (19.5%) had morbidity associated with congestive heart failure or prior myocardial infarction, perioperative hemoglobin decrease >3.1 g/dL, preoperative hemoglobin <12.0 g/dL, and prior thrombosis (c-index = 0.68). Predicted morbidity was similar to observed rates in the validation sample. Conclusion: History of congestive heart failure or myocardial infarction, prior thrombosis, perioperative hemoglobin decrease >3.1 g/dL, or preoperative hemoglobin <12.0 g/dL were associated with increased perioperative complications. Quality improvement efforts should modify these variables to optimize outcomes.
Original language | English (US) |
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Pages (from-to) | 137.e1-137.e5 |
Journal | American journal of obstetrics and gynecology |
Volume | 202 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2010 |
Keywords
- perioperative morbidity
- risk adjustment
- vaginal hysterectomy
ASJC Scopus subject areas
- Obstetrics and Gynecology