All-cause 30-day mortality associated with hysterectomy in Sweden from 2015 to 2021 using data from the Swedish perioperative register

Abstract

Objective

Hysterectomy is one of the most common gynaecological procedures. All-cause mortality within 30 days is an important indicator of care quality.

The primary objectives of this quality project were to study all-cause 30-day mortality following hysterectomy in Sweden and the impact of age, ASA class, and malignant indication on outcomes.

Population and methods

All hysterectomy procedures documented in the Swedish Perioperative Register (SPOR) were included from 2015 to 01-01 until 2021-12-31. Patient demographics and perioperative observations were collected and analysed.

Main outcome measure

All-cause 30-day mortality.

Results

The study cohort consisted of 25,391 patients with a mean age of 55.0 ± 13.8, and 54 % of patients were ASA I-II. All-cause 30-day mortality was low: only 1 patient died within the first 24 h, and 23 deaths were noted within 30 days among 25,391 procedures studied; equal to a perioperative mortality rate (POMR) 0.09 %. Higher age, higher ASA class, malignant indication, and combined general and neuraxial anaesthesia increased numerical POMR. Elderly (>65-years) and ASA III-IV were associated with significant increased un- and adjusted Odds Ratio for death within 30-days at 4.3 (95%CI 1.3–14.3, p = 0.02) and 15.3 (95%CI 4.8–84.4, p = 0.001) respectively.

Conclusions

All-cause 30-day mortality associated with hysterectomy in Sweden during recent years is low with a POMR of 0.09 %. Higher age and more pronounced higher ASA class increased the odds ratio for all-cause 30-day mortality. Further efforts to optimise the perioperative care of elderly and frail patients are important.