Vaginal hysterectomy outcomes; Complications and analysis of risk factors for 30-day readmission.
Saeed H, Rubinfeld I, and Sangha R. Vaginal hysterectomy outcomes; Complications and analysis of risk factors for 30-day readmission. J Minim Invasive Gynecol 2017; 24(7):S74-S75.
J Minim Invasive Gynecol
Study Objective: Vaginal hysterectomy is the preferred minimally invasive route for hysterectomy. Literature suggests low infectious morbidity. We sought to analyze our outcomes and assess risk factors for readmission. Design: Retrospective review of database. Setting: National Surgical Quality Improvement Project database ( NSQIP) Patients:Women who underwent vaginal hysterectomy, between 2005 and 2015. Intervention: Vaginal hysterectomy. Measurements and Main Results: We queried 11 years of the National Surgical Quality Improvement Project ( NSQIP)Participant Use File (PUF), 2005-2015. CPT codes for vaginal, including laparoscopic assisted vaginal hysterectomy were chosen. Data was analyzed in R with univariate followed by multivariate analysis. There were 17646 cases with 466 readmissions (2.6%). Complication rate was low (0.01%) with low rates for pulmonary embolism ( 0.01%) and wound infection ( 0.02%). The mean total length of stay was 1.35 days with 1.7% of patients returning to the operating room. Readmissions were younger were more likely to be diabetic (p < .001), they also had higher ASA scores (p < .001). Similar patterns were noted with smoking history, dyspnea and fraility index. Conclusion: Vaginal hysterectomy demonstrates low complication rates. Wound infection is not a significant contributor to readmission in these patients unlike in other routes of hysterectomy. Preoperative optimization of functional status and medical conditions like diabetes will further reduce readmission risk in women undergoing vaginal hysterectomy.