TABLE 5.
Predictors of postoperative complications by patient, surgeon, and hospital characteristics
| Characteristic | Adjusted odds ratiosa (95% CI) |
|---|---|
| Procedure | |
| Open | Reference |
| MIS | 0.22 (0.17–0.27)b |
| Surgeon hysterectomy volume | |
| 1–5 | 1.73 (1.22–2.47)b |
| 6–10 | 1.60 (1.11–2.23)b |
| 11–20 | 1.05 (0.74–1.49) |
| ≥21 | Reference |
| Hospital hysterectomy volume | |
| 1–100 | 2.26 (1.60–3.20)b |
| 101–200 | 1.63 (1.23–2.16)b |
| ≥201 | Reference |
| Beds | |
| <99 | 0.27 (0.11–0.65)b |
| 100–399 | 0.59 (0.45–0.78) |
| ≥400 | Reference |
| Years practicing | |
| <20 | Reference |
| ≥20 | 0.82 (0.63–1.06) |
| Patient age, y | |
| <20 | – |
| 20–44 | 1.09 (0.92–1.30) |
| 45–64 | Reference |
| ≥65 | 1.19(0.77–1.85) |
| Patient race | |
| White | Reference |
| Black | 1.45 (1.18–1.79)b |
| Hispanic ethnicity | 1.54 (0.99–2.38) |
| Other | 1.32 (0.97–1.80) |
| Payer, % | |
| Medicare | 1.86 (1.33–2.61)b |
| Medicaid | 1.63 (1.30–2.04)b |
| Self-pay | 2.41 (1.40–4.12)b |
| Commercial/private | Reference |
| Other | 0.85 (0.52–1.38) |
| Elixhauser score | |
| 0–1 | Reference |
| 2–4 | 1.67 (1.42–1.97)b |
| >5 | 4.58 (3.07–6.84)b |
| Fibroids | |
| Yes | 0.87(0.71–1.07) |
| No | Reference |
| Endometriosis | |
| Yes | 1.48 (1.19–1.83)b |
| No | Reference |
| Abnormal menstruation bleeding | |
| Yes | 0.80 (0.68–0.95)b |
| No | Reference |
| Benign neoplasm or cyst | |
| Yes | 1.07 (0.88–1.30) |
| No | Reference |
| Pelvic organ prolapse | |
| Yes | 0.66 (0.44–0.99) |
| No | Reference |
CI, confidence interval; MIS, minimally invasive surgery.
a
Multivariable regression adjusted for operative technique (MIS vs open), surgeon hysterectomy volume, hospital hysterectomy volume, hospital bed size, surgeon practicing year, patient age, patient race, payer, Elixhauser score, and all 5 selected benign indications;
b
Odds ratios and 95% confidence intervals represent significant values.
Mehta et al. Disparities associated with benign hysterectomy approach and complications. Am J Obstet Gynecol 2017.