Morbidity associated with vaginal hysterectomies in Queensland public teaching hospitals

Abstract

Hysterectomies performed vaginally are associated with less perioperative risk than those performed abdominally but the risk is not negligible. There are little sizable and/or contemporary Australian data of adverse outcomes associated with vaginal hysterectomy available. A retrospective analysis was undertaken in each of five Queensland public teaching hospitals of the last 200 women in each centre who underwent a vaginal hysterectomy for benign reasons. Serious morbidity complicated 14.0% of vaginal hysterectomies, minor morbidity was associated with 24.0% of hysterectomies and, overall, 29.9% suffered any (ie serious or minor) morbidity. Following multivariate analysis there remained an association between serious perioperative morbidity and ASA > or = 2 (relative risk (RR) 1.89 (1.37-2.61)) and omission of prophylactic antibiotics (RR 2.0 (1.45-2.78)). There also remained an association between any morbidity and use of antidepressants (RR 1.35 (1.07-1.72)), epilepsy (RR 2.00 (136-2.95)), preoperative hypoalbuminaemia (albumin < or = 35 g/L RR 2.08 (1.33-3.24)) as well as ASA > or = 2 (RR 1.24 (1.00-1.54)) and omission of prophylactic antibiotics (RR 1.45 (1.18-1.79)).