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Complications after benign hysterectomy, according to procedure: a population-based prospective cohort study from the Danish hysterectomy database, 2004–2015

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Settnes, Annette ; Moeller, Charlotte ; Topsoee, Märta Fink ; Norrbom, Christina ; Kopp, Tine Iskov ; Dreisler, Eva ; Joergensen, Annemette ; Dueholm, Margit ; Rasmussen, Steen Christian ; Froeslev, Pia Arnum ; Ottesen, Bent ; Gimbel, Helga. / Complications after benign hysterectomy, according to procedure : a population-based prospective cohort study from the Danish hysterectomy database, 2004–2015. In: BJOG : an international journal of obstetrics and gynaecology. 2020 ; Vol. 127, No. 10. pp. 1269-1279.

Bibtex

@article{0456268eab52434f8737b21e8c0c50f1,
title = "Complications after benign hysterectomy, according to procedure: a population-based prospective cohort study from the Danish hysterectomy database, 2004–2015",
abstract = "Objective: To compare the risk of complications associated with benign hysterectomy according to surgical procedure. Design: Register-based prospective cohort study. Setting: Danish Hysterectomy Database, 2004–2015. Population: All Danish women with benign elective hysterectomy (n = 51 141). Methods: Multivariate log-binomial regression to compute relative risks (RRs) stratified by calendar period, and adjusted for age, height, weight, smoking habits, use of alcohol, comorbidity, indications, uterine weight and adhesions. Multiple imputation and {\textquoteleft}intention to treat{\textquoteright} analyses were performed. Main outcome measures: Major (grades III–V) and minor (grades I–II) Clavien–Dindo modified complications within 30 days. Results: Overall, major complications occurred in 3577 (7.0%) hysterectomies and minor complications occurred in 4788 (9.4%). The proportions of major and minor complications according to type of hysterectomy were: 10.3 and 9.6% for abdominal hysterectomy (AH); 4.1 and 12.1% for laparoscopic hysterectomy (LH); and 4.9 and 8.0% for vaginal hysterectomy (VH) for non-prolapse, and 2.3 and 6.4% for prolapse. In multivariate analyses, compared with VH for non-prolapse, the risk of major complications was higher for AH (RR 1.82, 95% CI 1.63–2.03) but lower for both LH (RR 0.78, 95% CI 0.68–0.90) and VH for prolapse (RR 0.55; 95% CI 0.41–0.75). For LH, the risk of major complications reduced from a RR of 0.96 (95% CI 0.75–1.22) in the time period 2004–2009 to an RR of 0.72 (95% CI 0.60–0.87) between 2010 and 2015. Conclusion: Laparoscopic hysterectomy and VH for uterine prolapse are associated with fewer major complications, and AH is associated with more major complications, compared with VH performed in the absence of uterine prolapse. Tweetable abstract: Laparoscopic hysterectomy has fewer major complications compared with vaginal hysterectomy, in the absence of uterine prolapse.",
keywords = "Adult, Denmark/epidemiology, Female, Humans, Hysterectomy, Vaginal/adverse effects, Hysterectomy/adverse effects, Laparoscopy/adverse effects, Length of Stay/statistics & numerical data, Middle Aged, Postoperative Complications/epidemiology, Prospective Studies, Registries",
author = "Annette Settnes and Charlotte Moeller and Topsoee, {M{\"a}rta Fink} and Christina Norrbom and Kopp, {Tine Iskov} and Eva Dreisler and Annemette Joergensen and Margit Dueholm and Rasmussen, {Steen Christian} and Froeslev, {Pia Arnum} and Bent Ottesen and Helga Gimbel",
note = "{\textcopyright} 2020 Royal College of Obstetricians and Gynaecologists.",
year = "2020",
month = sep,
doi = "10.1111/1471-0528.16200",
language = "English",
volume = "127",
pages = "1269--1279",
journal = "BJOG: An International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "10",

}

RIS

TY - JOUR

T1 - Complications after benign hysterectomy, according to procedure

T2 - a population-based prospective cohort study from the Danish hysterectomy database, 2004–2015

AU - Settnes, Annette

AU - Moeller, Charlotte

AU - Topsoee, Märta Fink

AU - Norrbom, Christina

AU - Kopp, Tine Iskov

AU - Dreisler, Eva

AU - Joergensen, Annemette

AU - Dueholm, Margit

AU - Rasmussen, Steen Christian

AU - Froeslev, Pia Arnum

AU - Ottesen, Bent

AU - Gimbel, Helga

N1 - © 2020 Royal College of Obstetricians and Gynaecologists.

PY - 2020/9

Y1 - 2020/9

N2 - Objective: To compare the risk of complications associated with benign hysterectomy according to surgical procedure. Design: Register-based prospective cohort study. Setting: Danish Hysterectomy Database, 2004–2015. Population: All Danish women with benign elective hysterectomy (n = 51 141). Methods: Multivariate log-binomial regression to compute relative risks (RRs) stratified by calendar period, and adjusted for age, height, weight, smoking habits, use of alcohol, comorbidity, indications, uterine weight and adhesions. Multiple imputation and ‘intention to treat’ analyses were performed. Main outcome measures: Major (grades III–V) and minor (grades I–II) Clavien–Dindo modified complications within 30 days. Results: Overall, major complications occurred in 3577 (7.0%) hysterectomies and minor complications occurred in 4788 (9.4%). The proportions of major and minor complications according to type of hysterectomy were: 10.3 and 9.6% for abdominal hysterectomy (AH); 4.1 and 12.1% for laparoscopic hysterectomy (LH); and 4.9 and 8.0% for vaginal hysterectomy (VH) for non-prolapse, and 2.3 and 6.4% for prolapse. In multivariate analyses, compared with VH for non-prolapse, the risk of major complications was higher for AH (RR 1.82, 95% CI 1.63–2.03) but lower for both LH (RR 0.78, 95% CI 0.68–0.90) and VH for prolapse (RR 0.55; 95% CI 0.41–0.75). For LH, the risk of major complications reduced from a RR of 0.96 (95% CI 0.75–1.22) in the time period 2004–2009 to an RR of 0.72 (95% CI 0.60–0.87) between 2010 and 2015. Conclusion: Laparoscopic hysterectomy and VH for uterine prolapse are associated with fewer major complications, and AH is associated with more major complications, compared with VH performed in the absence of uterine prolapse. Tweetable abstract: Laparoscopic hysterectomy has fewer major complications compared with vaginal hysterectomy, in the absence of uterine prolapse.

AB - Objective: To compare the risk of complications associated with benign hysterectomy according to surgical procedure. Design: Register-based prospective cohort study. Setting: Danish Hysterectomy Database, 2004–2015. Population: All Danish women with benign elective hysterectomy (n = 51 141). Methods: Multivariate log-binomial regression to compute relative risks (RRs) stratified by calendar period, and adjusted for age, height, weight, smoking habits, use of alcohol, comorbidity, indications, uterine weight and adhesions. Multiple imputation and ‘intention to treat’ analyses were performed. Main outcome measures: Major (grades III–V) and minor (grades I–II) Clavien–Dindo modified complications within 30 days. Results: Overall, major complications occurred in 3577 (7.0%) hysterectomies and minor complications occurred in 4788 (9.4%). The proportions of major and minor complications according to type of hysterectomy were: 10.3 and 9.6% for abdominal hysterectomy (AH); 4.1 and 12.1% for laparoscopic hysterectomy (LH); and 4.9 and 8.0% for vaginal hysterectomy (VH) for non-prolapse, and 2.3 and 6.4% for prolapse. In multivariate analyses, compared with VH for non-prolapse, the risk of major complications was higher for AH (RR 1.82, 95% CI 1.63–2.03) but lower for both LH (RR 0.78, 95% CI 0.68–0.90) and VH for prolapse (RR 0.55; 95% CI 0.41–0.75). For LH, the risk of major complications reduced from a RR of 0.96 (95% CI 0.75–1.22) in the time period 2004–2009 to an RR of 0.72 (95% CI 0.60–0.87) between 2010 and 2015. Conclusion: Laparoscopic hysterectomy and VH for uterine prolapse are associated with fewer major complications, and AH is associated with more major complications, compared with VH performed in the absence of uterine prolapse. Tweetable abstract: Laparoscopic hysterectomy has fewer major complications compared with vaginal hysterectomy, in the absence of uterine prolapse.

KW - Adult

KW - Denmark/epidemiology

KW - Female

KW - Humans

KW - Hysterectomy, Vaginal/adverse effects

KW - Hysterectomy/adverse effects

KW - Laparoscopy/adverse effects

KW - Length of Stay/statistics & numerical data

KW - Middle Aged

KW - Postoperative Complications/epidemiology

KW - Prospective Studies

KW - Registries

U2 - 10.1111/1471-0528.16200

DO - 10.1111/1471-0528.16200

M3 - Journal article

C2 - 32145133

VL - 127

SP - 1269

EP - 1279

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 10

ER -

ID: 59580664