Abstract 4201: Patient-level predictors and hysterectomies among women with autoimmune diseases

Abstract

Abstract Introduction: Hysterectomy is the second most common surgical procedure performed among reproductive aged women. The primary reason for hysterectomy among women 35-54 years is uterine fibroids and for older women is uterine prolapse or gynecologic (GYN) cancer. According to the National Center for Health Statistics, an estimated 600,000 hysterectomies are performed annually in the U.S. with an annual cost of $5 billion, which makes hysterectomy a major public health concern. Autoimmune diseases (AD) are among the top ten leading causes of death among U.S. women age 65 and under. This high mortality rate among women with AD has been linked to cancer and other causes. Considering hysterectomy procedures as are invasive and costly procedures, a comprehensive study to investigate the association between patient-level predictors and hysterectomy procedures among AD patients in the U.S. is imperative. Methods: 2007-2013 data from Florida State Inpatient samples of the Healthcare Cost and Utilization Project were used. The study population (n=699,280) was restricted to women who had any AD. The outcome variable was performance of hysterectomy, identified by CPT codes. Patient-level factors including race/ethnicity, age, insurance type, income level, and other comorbidities were analyzed as explanatory variables. Logistic regression analyses were used to identify independent predictors of hysterectomy procedures. Results: Among AD subjects, the highest rate of hysterectomy was in Caucasian women (64.64%) and the lowest rate was in minorities other than Black and Hispanic women (3.0%). The odds of hysterectomies are were increased in older women who were older (0.74, 0.70-0.78), women, black (1.45, 1.36-1.54) women, have had private insurance (2.30, 2.14-2.45), and are fromhad lower income levels (1.10, 1.02-1.19), and had with more comorbid conditions, specifically GYN cancer. Discussion: GYN complications may lead to hysterectomy, and ADs are major diseases among women. Because of the high prevalence of AD among women, more elucidation on the association between hysterectomy procedures and AD is essential for GYN complications management. Any unique combinations of characteristics that describe patients at risk for hysterectomy among AD patients could be used as a potential risk assessment for better management of GYN complications, and in particular GYN cancer. Citation Format: Zahra Bahrani-Mostafavi, Larissa R. Huber. Patient-level predictors and hysterectomies among women with autoimmune diseases [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4201.