8412 Effects of the COVID-19 Pandemic on Women Seeking Hysterectomy for Abnormal Uterine Bleeding

Abstract

<h3>Study Objective</h3> Examine the effects of operating room closures during the COVID-19 pandemic for women undergoing hysterectomy for abnormal uterine bleeding (AUB) in a safety net hospital. <h3>Design</h3> Retrospective cohort analysis. <h3>Setting</h3> Academic County Hospital. <h3>Patients or Participants</h3> All patients 18 years or older undergoing a hysterectomy with the benign gynecology service for AUB from May 2018-December 2019 (pre-pandemic) and April 2020-November 2021 (pandemic) at our hospital. A total of 556 patients met inclusion criteria, 401 prior to, and 155 during the pandemic. <h3>Interventions</h3> Laparoscopic, abdominal, and vaginal hysterectomy. <h3>Measurements and Main Results</h3> Pandemic patients were more likely to have a lower starting Hemoglobin (p <0.05), history of blood transfusion (p <0.05) and a lower Hemoglobin nadir (p < 0.05) than patients prior to the pandemic. They were also more likely to be medically managed while awaiting surgery (p < 0.05). The average wait time between decision for hysterectomy and surgery date pre-pandemic was 30 days compared to 121 days during the pandemic (p < 0.05). While awaiting surgery, pandemic patients were significantly more likely to receive blood transfusions (OR 6.7, 95% CI 3.5, 12.8), return to the clinic (OR 21.1, 95% CI 12.6, 35.1), and be seen in the EC for AUB complaints (OR 6.6, 95% CI 3.8, 11.5) than pre-pandemic patients. When controlling for starting Hemoglobin, history of transfusion, Hemoglobin nadir, and use of medical management, this effect persisted, indicating that the length of time patients waited for surgery was significantly associated with the outcome measures. <h3>Conclusion</h3> Women needing a hysterectomy for AUB in our hospital waited three months longer for surgery during the pandemic compared to prior to the pandemic. Additionally, while awaiting surgery, patients were seen in the EC and office more frequently and required more blood transfusions. The effects of COVID have been far-reaching, and gynecologic care for our patient population has been significantly, negatively impacted.