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Incidence of and Risk Factors for Postoperative Venous Thromboembolism in Benign Hysterectomy. J Minim Invasive Gynecol 2022 Feb;29(2):231-236.e1

Date

08/12/2021

Pubmed ID

34380073

DOI

10.1016/j.jmig.2021.08.004

Scopus ID

2-s2.0-85113861661

Abstract

STUDY OBJECTIVE: Describe the incidence of and risk factors associated with postoperative venous thromboembolism (VTE) in patients undergoing hysterectomy for benign indications with emphasis on the impact of route of surgery.

DESIGN: Retrospective cohort.

SETTING: National Surgical Quality Improvement Project Database.

PARTICIPANTS: Data of women aged 18 years and older who underwent hysterectomy for benign indications between 2014 and 2018 were abstracted.

INTERVENTIONS: Cases were identified by Current Procedural Terminology codes and International Classification of Diseases codes. Patient demographics, preoperative comorbidities, American Society of Anesthesiologists (ASA) classification system scores, total operating time, length of stay, readmission, reoperation, VTE including deep vein thrombosis and pulmonary embolism were collected. Cases were stratified by route of hysterectomy.

MEASUREMENTS AND MAIN RESULTS: t test and multivariable logistic regression were used for analysis. A total of 94 940 patients underwent hysterectomy, of which 23 081 (24.3%) underwent abdominal hysterectomy, 56 656 (59.7 %) laparoscopic hysterectomy, and 15 203 (16.0%) vaginal hysterectomy. The overall incidence of VTE was 0.4%. The incidence of VTE was higher for abdominal (0.7%), than laparoscopic (0.3%, p <.001), and vaginal hysterectomy (0.2%, p <.001). Higher ASA classification was independently associated with postoperative VTE. Age, race, body mass index, uterine weight, operative time, multiple medical comorbidities, and smoking status were not independently associated with increased risk of VTE.

CONCLUSION: Postoperative VTE after hysterectomy for benign indications is rare. The risk of postoperative VTE is higher in patients undergoing abdominal hysterectomy compared with minimally invasive hysterectomy including laparoscopic and vaginal routes of surgery. In addition, the risk of VTE may be higher with higher ASA class.

Author List

Duyar S, Mou T, Mueller MG, Kenton KS, Bretschneider CE

Author

Susan Duyar MD Gynecology Oncology Fellow in the Obstetrics & Gynecology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Female
Humans
Hysterectomy
Incidence
Postoperative Complications
Retrospective Studies
Risk Factors
Venous Thromboembolism