Does Obesity and Procedure Type Increase the Risk of in-Hospital Mortality in Laparoscopic Hysterectomy?

Abstract

Study Objective To assess the differences in demographics and laparoscopic hysterectomy type by comorbid obesity and to assess the risk of in-hospital mortality due to obesity and other comorbidities. Design We conducted a cross-sectional data analysis using the healthcare cost and utilization project's (HCUP) nationwide inpatient sample (NIS) data from 2012 to 2014. Setting In-patient data using the NIS that provides patient records from about 4,400 non-federal hospitals and covers 45 states in the US. Patients or Participants We identified 119,890 adult females undergoing laparoscopic hysterectomies based on ICD-9 procedure codes. We identified differences in demographic, comorbidities and procedure types between obesity (N=17,370) and non-obesity (N=102,520) cohorts. Further, we used logistic regression model adjusted for confounders to assess the odds ratio (OR) of obesity on in-hospital mortality. Interventions Total laparoscopic hysterectomy (TLH), laparoscopic assisted vaginal hysterectomy (LAVH), and laparoscopic supracervical hysterectomy (LSH). Measurements and Main Results Majority of the inpatients underwent TLH (51.3%), followed by LAVH (25.8%) and LSH (12.9%). Majority of the inpatients were middle-age adults 36 to 50 years (83.1%) and White (67.7%) with obesity cohort older than non-obesity (51.3y vs. 48.8y, P Conclusion Analysis of national-level data shows that obese patients have increased perioperative mortality with a higher prevalence of co-morbidities. More research studies should focus on improving these outcomes in obese patients.