Leslie K. Palacios-Helgeson MD , Ashish Premkumar MD , Jacqueline M.K. Wong MD , Claire H. Gould MD , Megan A. Cahn PhD , Blake C. Osmundsen MD
{"title":"以子宫大小为替代对照的子宫切除术路径种族差异国家数据库研究:良性适应症的质量指标建议。","authors":"Leslie K. Palacios-Helgeson MD , Ashish Premkumar MD , Jacqueline M.K. Wong MD , Claire H. Gould MD , Megan A. Cahn PhD , Blake C. Osmundsen MD","doi":"10.1016/j.jmig.2024.07.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Study Objective</h3><div>To investigate the association between race and route of hysterectomy among patients undergoing hysterectomy for abnormal uterine bleeding (AUB) in the absence of uterine myoma disease and excluding malignancy.</div></div><div><h3>Design</h3><div>A cross-sectional cohort study utilizing the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and National Ambulatory Surgical databases to compare abdominal to minimally invasive routes of hysterectomy.</div></div><div><h3>Setting</h3><div>Hospitals and hospital-affiliated ambulatory surgical centers participating in the Healthcare Cost and Utilization Project in 2019.</div></div><div><h3>Patients</h3><div>A total of 75 838 patients who had undergone hysterectomy for AUB, excluding uterine myoma and malignancy.</div></div><div><h3>Interventions</h3><div>n/a</div></div><div><h3>Measurements and Main Results</h3><div>Of the 75 838 hysterectomies performed for AUB in the absence of uterine myomas and malignancy, 10.1% were performed abdominally and 89.9% minimally invasively. After adjusting for confounders, Black patients were 38% more likely to undergo abdominal hysterectomy compared to White patients (OR 1.38, CI 1.12–1.70 p = .002). Black race, thus, is independently associated with open surgery.</div></div><div><h3>Conclusion</h3><div>Despite excluding uterine myomas as a risk factor for an abdominal route of hysterectomy, Black race remained an independent predictor for abdominal versus minimally invasive hysterectomy, and Black patients were found to undergo a disproportionately higher rate of abdominal hysterectomy compared to White patients.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Pages 929-935"},"PeriodicalIF":3.5000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A National Database Study on Racial Disparities in Route of Hysterectomy With a Surrogate Control for Uterine Size: A Proposed Quality Metric for Benign Indications\",\"authors\":\"Leslie K. 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Osmundsen MD\",\"doi\":\"10.1016/j.jmig.2024.07.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Study Objective</h3><div>To investigate the association between race and route of hysterectomy among patients undergoing hysterectomy for abnormal uterine bleeding (AUB) in the absence of uterine myoma disease and excluding malignancy.</div></div><div><h3>Design</h3><div>A cross-sectional cohort study utilizing the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and National Ambulatory Surgical databases to compare abdominal to minimally invasive routes of hysterectomy.</div></div><div><h3>Setting</h3><div>Hospitals and hospital-affiliated ambulatory surgical centers participating in the Healthcare Cost and Utilization Project in 2019.</div></div><div><h3>Patients</h3><div>A total of 75 838 patients who had undergone hysterectomy for AUB, excluding uterine myoma and malignancy.</div></div><div><h3>Interventions</h3><div>n/a</div></div><div><h3>Measurements and Main Results</h3><div>Of the 75 838 hysterectomies performed for AUB in the absence of uterine myomas and malignancy, 10.1% were performed abdominally and 89.9% minimally invasively. After adjusting for confounders, Black patients were 38% more likely to undergo abdominal hysterectomy compared to White patients (OR 1.38, CI 1.12–1.70 p = .002). Black race, thus, is independently associated with open surgery.</div></div><div><h3>Conclusion</h3><div>Despite excluding uterine myomas as a risk factor for an abdominal route of hysterectomy, Black race remained an independent predictor for abdominal versus minimally invasive hysterectomy, and Black patients were found to undergo a disproportionately higher rate of abdominal hysterectomy compared to White patients.</div></div>\",\"PeriodicalId\":16397,\"journal\":{\"name\":\"Journal of minimally invasive gynecology\",\"volume\":\"31 11\",\"pages\":\"Pages 929-935\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of minimally invasive gynecology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1553465024003029\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of minimally invasive gynecology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553465024003029","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
A National Database Study on Racial Disparities in Route of Hysterectomy With a Surrogate Control for Uterine Size: A Proposed Quality Metric for Benign Indications
Study Objective
To investigate the association between race and route of hysterectomy among patients undergoing hysterectomy for abnormal uterine bleeding (AUB) in the absence of uterine myoma disease and excluding malignancy.
Design
A cross-sectional cohort study utilizing the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and National Ambulatory Surgical databases to compare abdominal to minimally invasive routes of hysterectomy.
Setting
Hospitals and hospital-affiliated ambulatory surgical centers participating in the Healthcare Cost and Utilization Project in 2019.
Patients
A total of 75 838 patients who had undergone hysterectomy for AUB, excluding uterine myoma and malignancy.
Interventions
n/a
Measurements and Main Results
Of the 75 838 hysterectomies performed for AUB in the absence of uterine myomas and malignancy, 10.1% were performed abdominally and 89.9% minimally invasively. After adjusting for confounders, Black patients were 38% more likely to undergo abdominal hysterectomy compared to White patients (OR 1.38, CI 1.12–1.70 p = .002). Black race, thus, is independently associated with open surgery.
Conclusion
Despite excluding uterine myomas as a risk factor for an abdominal route of hysterectomy, Black race remained an independent predictor for abdominal versus minimally invasive hysterectomy, and Black patients were found to undergo a disproportionately higher rate of abdominal hysterectomy compared to White patients.
期刊介绍:
The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.