Clinical Outcomes of Hysterectomies Using the National Surgical Quality Improvement Program Database [141

Abstract

INTRODUCTION: The National Surgical Quality Improvement Program from the American College of Surgeons is a nationwide clinical registry of surgical outcomes. The objective of this study was to obtain current clinical outcomes of hysterectomies using the National Surgical Quality Improvement Program Participant Use Data File. METHODS: Hysterectomies performed from January 2008 to December 2012 were extracted from the National Surgical Quality Improvement Program Participant Use Data File by Current Procedural Terminology (CPT) codes. Data were collected prospectively and represented a minimum of 10% of the surgical volume from 211 hospitals in 2008, 237 in 2009, 258 in 2010, 315 in 2011, and 374 in 2012. Cases were excluded for International Classification of Diseases, 9th Revisions (ICD-9) codes associated with malignancy (7,571), ineligible ICD-9 codes (7,114), and CPT codes (4,078) resulting in 49,249 benign cases available for analysis. The adverse outcomes evaluated included return to the operating room, unplanned readmissions, wound complications, venous thromboembolism, sepsis, blood transfusions, and urinary tract infection (UTI). The adverse outcomes included a 30-day postsurgical follow-up. RESULTS: The overall rate of any complication was 9.1%. Laparoscopic supracervical hysterectomy less than 250 g had the lowest complication rate at 5.64%. Total abdominal hysterectomy (TAH) had the highest complication rate at 13.3%. For TAH, the average complication rates were 1.92% for return to the operating room, 3.73% unplanned readmissions, 4.47% wound complications, 0.65% venous thromboembolism, 0.91% sepsis, 5.09% blood transfusions, and 2.45% UTI. CONCLUSION: This study represents a robust analysis of 30-day morbidity and mortality by type of hysterectomy performed on women in the United States, which was prospectively collected by a reliable method.