Models Predicting Complications of Hysterectomy Developed

MONDAY, Oct. 3, 2022 (HealthDay News) -- Models have been developed and validated for predicting major complications of laparoscopic or abdominal hysterectomy for benign conditions, according to a study published online Oct. 3 in CMAJ, the journal of the Canadian Medical Association.

Krupa Madhvani, M.D., from Barts and the London School of Medicine and Dentistry, and colleagues obtained routinely collected health administrative data from the English National Health Service from 2011 to 2018 to develop and validate models to predict major complications of laparoscopic or abdominal hysterectomy for benign conditions. Eleven predictors were specified a priori.

The researchers found that major complications occurred in 4.4 and 4.9 percent of 68,599 and 125,971 laparoscopic and abdominal hysterectomies, respectively. Consistent discrimination was seen in the models in the development cohort (C-statistics, 0.61 and 0.67 for laparoscopic and abdominal, respectively); in the validation cohort, discrimination was similar or better (C-statistics, 0.67 and 0.67 for laparoscopic and abdominal, respectively). In both models, adhesions were most predictive of complications (odds ratios, 1.92 and 2.46 for laparoscopic and abdominal, respectively). Adenomyosis was predictive of complications in the laparoscopic model, and Asian ethnicity and diabetes were predictive in the abdominal model. Age and diagnoses of menstrual disorders or benign adnexal mass were protective factors in both models, while diagnosis of fibroids was protective in the abdominal model.

"Most hysterectomies in Canada are for benign indications and, with calls for ongoing investment into gynecologic surgery, our models could be useful tools to stratify risk," the authors write.

Abstract/Full Text