Assessing the impact of body mass index (BMI) on quality outcomes among women undergoing hysterectomy for benign indications

Abstract

Objectives Determine the proportion of obese patients undergoing hysterectomy for benign indications and impact of BMI on quality metrics at the time of hysterectomy. Methods Retrospective review of all hysterectomies at seven Ontario hospitals (three academic, four community) was conducted between July 2016-June 2019, excluding pre-malignant, malignant and urgent surgical indications. Patient factors (age, ASA, pre-operative diagnoses, previous surgeries), surgical factors (technicity, presence of adhesions and endometriosis, uterine weight, concomitant procedures, operative time) and surgeon characteristics (volume, fellowship training) were recorded. Primary outcome was a composite of any complication or readmission. Secondary outcomes were Grade ≥2 complication, postoperative emergency department visit and readmission. Logistic regression grouping patients by BMI category (normal, overweight, obesity class 1, 2 and 3) evaluated variables associated with study outcomes. Results 2528 hysterectomies were performed (828 (33%) normalBMI, 889 (35%) overweight, 500 (20%) obesity class 1, 205 (8%) class 2 and 104 (4%) class 3). Compared to normal BMI, obese patients had higher ASA (p Conclusions BMI class was not independently associated with qualityoutcomes in patients undergoing hysterectomy for benign indications.