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。

IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
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
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引用次数: 0

摘要

研究目的调查在没有子宫肌瘤疾病且排除恶性肿瘤的情况下,因异常子宫出血而接受子宫切除术的患者中,种族与子宫切除术路径之间的关联:设计:一项横断面队列研究,利用医疗成本与利用项目全国住院病人样本和全国非住院手术数据库,比较腹部子宫切除术和微创子宫切除术的途径:参与2019年医疗成本与利用项目的医院和医院附属门诊手术中心:干预措施:不适用测量和主要结果:在75838例因子宫异常出血(不包括子宫肌瘤和恶性肿瘤)而进行的子宫切除术中,10.1%是腹腔手术,89.9%是微创手术。在对混杂因素进行调整后,黑人患者接受腹腔子宫切除术的几率比白人患者高出38%(OR 1.38,CI 1.12-1.70 p=0.002)。因此,黑人种族与开腹手术有独立关联:结论:尽管排除了子宫肌瘤作为腹式子宫切除术的风险因素,但黑人种族仍是腹式子宫切除术与微创子宫切除术的独立预测因素,黑人患者接受腹式子宫切除术的比例高于白人患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.
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来源期刊
CiteScore
5.00
自引率
7.30%
发文量
272
审稿时长
37 days
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.
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