OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment, and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relation.

DESIGN: Register-based cohort study.

SETTING AND POPULATION: The study included nearly all Danish women (n=22,150) registered with a benign elective hysterectomy in the Danish Hysterectomy Database in the 2004-2008 period.

MAIN OUTCOME MEASURES: Data were analyzed using logistic regression models estimating the odds ratio with 95% confidence intervals.

METHODS: Complications following hysterectomy.

RESULTS: Seventeen percent of the women experienced complications in relation to the hysterectomy. Women with less than high school education and women not employed had higher odds of infection, complications and readmission than women with more than high school education and employed women. Furthermore, non-employed women had higher odds of hospitalization >4 days than women in employment. Lifestyle factors (smoking and body mass index) and co-morbidity status seemed to explain most of the social differences. However, an association between women with less than high school education and all complications remained unexplained. Furthermore, differences in lifestyle and co-morbidity status only partially explained the higher odds of infection, complications and hospitalization >4 days for women out of employment compared to women in employment.

CONCLUSION: Women with low socioeconomic position have significantly higher odds of complications following hysterectomy than women with high socioeconomic position. Unhealthy lifestyle and presence of co-morbidity in women with low socioeconomic position partially explains the differences in complications. This article is protected by copyright. All rights reserved.