Table 3.

Rates of outcomes and adjusted risk ratio of surgeon volume in patients with any hysterectomy.

	Other		VLV		p-value	aRR, VLV vs. other
Outcomes	N	%	N	%
Any morbidity	42,423	9.9	1,437	32.0	<0.001	1.97 (1.86–2.09)*
Intraoperative complication	13,528	3.2	509	11.3	<0.001	2.41 (2.19–2.65)*
Surgical site complication	17,668	4.1	677	15.1	<0.001	1.96 (1.80–2.13)*
Medical complication	20,833	4.9	877	19.5	<0.001	2.18 (2.02–2.35)*
Mortality	666	0.2	113	2.5	<0.001	2.89 (2.32–3.61)*
Transfusion	50,740	11.8	1,728	38.5	<0.001	1.78 (1.68–1.88)*
LOS >75%	94,537	22.0	2,781	62.0	<0.001	1.55 (1.48–1.62)*
Total charges>75%	105,845	24.6	2,686	59.9	<0.001	1.89 (1.80–1.99)*

VLV: very low volume. aRR: adjusted risk ratio. LOS: length of stay.

Annualized surgeon and hospital volume were calculated for any hysterectomy. Mixed-effects log-Poisson models included surgeon volume, elective surgery, age, year of admission, race, insurance status, comorbidity, NYC hospital, hospital-level tertiles of hospital volume, concomitant procedures (omentectomy, lymphadenectomy, anterior, posterior and incontinence repair, oophorectomy and colpopexy), indications (leiomyoma, endometriosis, abnormal menstruation and bleeding, benign neoplasms and cysts, pelvic organ prolapse, endometrial hyperplasia with or without atypia, uterine, cervical, and ovarian/fallopian tube/peritoneal cancer) and route of hysterectomy. Surgeon and hospital identifiers were included as nested random intercepts to account for surgeon and hospital level of clustering.

^*p-value<0.05