Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies
The objective of our study was to provide a contemporary description of hysterectomy practice and temporal trends in Canada. A national whole-population retrospective analysis of data from the Canadian Institute for Health Information. Canada. All women who underwent hysterectomy for benign indicati...
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| Veröffentlicht in: | Journal of minimally invasive gynecology 2021-05, Vol.28 (5), p.1041-1050 |
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| creator | Chen, Innie Mallick, Ranjeeta Allaire, Catherine Bajzak, Krisztina I. Belland, Liane M. Bougie, Olga Cassell, Krista A. Choudhry, Abdul J. Cundiff, Geoffrey W. Kroft, Jamie Leyland, Nicholas A. Maheux-Lacroix, Sarah Rajakumar, Chandrew Randle, Elizabeth Robertson, Deborah Thiel, John A. Tulandi, Togas Yong, Paul J. Laberge, Philippe Y. |
| description | The objective of our study was to provide a contemporary description of hysterectomy practice and temporal trends in Canada.
A national whole-population retrospective analysis of data from the Canadian Institute for Health Information.
Canada.
All women who underwent hysterectomy for benign indication from April 1, 2007, to March 31, 2017, in Canada.
Hysterectomy.
A total of 369 520 hysterectomies were performed in Canada during the 10-year period, during which the hysterectomy rate decreased from 313 to 243 per 100 000 women. The proportion of abdominal hysterectomies decreased (59.5% to 36.9%), laparoscopic hysterectomies increased (10.8% to 38.6%), and vaginal hysterectomies decreased (29.7% to 24.5%), whereas the national technicity index increased from 40.5% to 63.1% (p |
| doi_str_mv | 10.1016/j.jmig.2021.01.010 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2480267862</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1553465021000388</els_id><sourcerecordid>2480267862</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-8cbdebd0534b88d91621e33e318cd1a43de958fd12ad18a09c9a987797cd0ba03</originalsourceid><addsrcrecordid>eNp9kMtq3DAUQEVoyfsHsihaduPJleWHXLoZhrwgfSwm7VLI0p1GgyxNJc8Eb_PlsTNploULEuLowD2EXDCYMWDV5Xq27uyfWQ45m8E0cECOWVnyrKiq5sP7vYQjcpLSGoDXANUhOeK8qKu6hGPyvET96K22_UCtpwvllVFf6Jx-V70N_skapL8fg8PsZ9hs3esjnXvlhmQTDSu6xG4TonJ0GdGbRJU39JeKdk-Oym_W2045N9A7v1PJ7pDeDqnHiLoPncV0Rj6ulEt4_naekofrq-XiNrv_cXO3mN9nugDoM6Fbg62BkhetEKZhVc6Qc-RMaMNUwQ02pVgZlivDhIJGN6oRdd3U2kCrgJ-Sz3vvJoa_W0y97GzS6JzyGLZJ5oWAvKpFlY9ovkd1DClFXMlNHJeIg2Qgp_ZyLaf2cmovYZrJ_-nNv207NO9f_sUega97AMctdxajTNqi12jsFEOaYP_nfwFkZJdM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2480267862</pqid></control><display><type>article</type><title>Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies</title><source>Elsevier ScienceDirect Journals Complete</source><creator>Chen, Innie ; Mallick, Ranjeeta ; Allaire, Catherine ; Bajzak, Krisztina I. ; Belland, Liane M. ; Bougie, Olga ; Cassell, Krista A. ; Choudhry, Abdul J. ; Cundiff, Geoffrey W. ; Kroft, Jamie ; Leyland, Nicholas A. ; Maheux-Lacroix, Sarah ; Rajakumar, Chandrew ; Randle, Elizabeth ; Robertson, Deborah ; Thiel, John A. ; Tulandi, Togas ; Yong, Paul J. ; Laberge, Philippe Y.</creator><creatorcontrib>Chen, Innie ; Mallick, Ranjeeta ; Allaire, Catherine ; Bajzak, Krisztina I. ; Belland, Liane M. ; Bougie, Olga ; Cassell, Krista A. ; Choudhry, Abdul J. ; Cundiff, Geoffrey W. ; Kroft, Jamie ; Leyland, Nicholas A. ; Maheux-Lacroix, Sarah ; Rajakumar, Chandrew ; Randle, Elizabeth ; Robertson, Deborah ; Thiel, John A. ; Tulandi, Togas ; Yong, Paul J. ; Laberge, Philippe Y. ; for the Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration ; Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration</creatorcontrib><description>The objective of our study was to provide a contemporary description of hysterectomy practice and temporal trends in Canada.
A national whole-population retrospective analysis of data from the Canadian Institute for Health Information.
Canada.
All women who underwent hysterectomy for benign indication from April 1, 2007, to March 31, 2017, in Canada.
Hysterectomy.
A total of 369 520 hysterectomies were performed in Canada during the 10-year period, during which the hysterectomy rate decreased from 313 to 243 per 100 000 women. The proportion of abdominal hysterectomies decreased (59.5% to 36.9%), laparoscopic hysterectomies increased (10.8% to 38.6%), and vaginal hysterectomies decreased (29.7% to 24.5%), whereas the national technicity index increased from 40.5% to 63.1% (p <.001, all trends). The median length of stay decreased from 3 (interquartile range 2–4) days to 2 (interquartile range 1–3), and the proportion of patients discharged within 24 hours increased from 2.1% to 7.2%.
In year 2016-17, women aged 40 to 49 years had significantly increased risk of abdominal hysterectomy compared with women undergoing hysterectomy in other age categories (p <.001). Comparing women with menstrual bleeding disorders, women undergoing hysterectomy for endometriosis (adjusted relative risk [aRR] 1.36; 95% confidence interval [CI], 1.28–1.44) and myomas (aRR 2.01; 95% CI, 1.94–2.08) were at increased risk of abdominal hysterectomy, whereas women undergoing hysterectomy for pelvic organ prolapse and pelvic pain (aRR 1.47; 95% CI, 1.41–1.53) were at decreased risk.
Using Ontario as the comparator, Nova Scotia (aRR 1.35; 95% CI, 1.27–1.43), New Brunswick (aRR 1.25; 95% CI, 1.18–1.32]), Manitoba (aRR 1.35; 95% CI, 1.28–1.43), and Newfoundland and Labrador (aRR 1.18; 95% CI, 1.10–1.27) had significantly higher risks of abdominal hysterectomy. In contrast, Saskatchewan (aRR 0.75; 95% CI, 0.74–0.77) and British Columbia (aRR 0.86; 95% CI, 0.85–0.88) had significantly lower risks, whereas Prince Edward Island, Quebec, and Alberta were not significantly different.
The proportion of minimally invasive hysterectomies for benign indication has increased significantly in Canada. The declining use of vaginal approaches and the variation among provinces are of concern and necessitate further study.</description><identifier>ISSN: 1553-4650</identifier><identifier>EISSN: 1553-4669</identifier><identifier>DOI: 10.1016/j.jmig.2021.01.010</identifier><identifier>PMID: 33476750</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdominal hysterectomy ; Hysterectomy ; Interprovincial variation ; Laparoscopic hysterectomy ; Vaginal hysterectomy</subject><ispartof>Journal of minimally invasive gynecology, 2021-05, Vol.28 (5), p.1041-1050</ispartof><rights>2021 AAGL</rights><rights>Copyright © 2021 AAGL. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-8cbdebd0534b88d91621e33e318cd1a43de958fd12ad18a09c9a987797cd0ba03</citedby><cites>FETCH-LOGICAL-c400t-8cbdebd0534b88d91621e33e318cd1a43de958fd12ad18a09c9a987797cd0ba03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jmig.2021.01.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33476750$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Innie</creatorcontrib><creatorcontrib>Mallick, Ranjeeta</creatorcontrib><creatorcontrib>Allaire, Catherine</creatorcontrib><creatorcontrib>Bajzak, Krisztina I.</creatorcontrib><creatorcontrib>Belland, Liane M.</creatorcontrib><creatorcontrib>Bougie, Olga</creatorcontrib><creatorcontrib>Cassell, Krista A.</creatorcontrib><creatorcontrib>Choudhry, Abdul J.</creatorcontrib><creatorcontrib>Cundiff, Geoffrey W.</creatorcontrib><creatorcontrib>Kroft, Jamie</creatorcontrib><creatorcontrib>Leyland, Nicholas A.</creatorcontrib><creatorcontrib>Maheux-Lacroix, Sarah</creatorcontrib><creatorcontrib>Rajakumar, Chandrew</creatorcontrib><creatorcontrib>Randle, Elizabeth</creatorcontrib><creatorcontrib>Robertson, Deborah</creatorcontrib><creatorcontrib>Thiel, John A.</creatorcontrib><creatorcontrib>Tulandi, Togas</creatorcontrib><creatorcontrib>Yong, Paul J.</creatorcontrib><creatorcontrib>Laberge, Philippe Y.</creatorcontrib><creatorcontrib>for the Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration</creatorcontrib><creatorcontrib>Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration</creatorcontrib><title>Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies</title><title>Journal of minimally invasive gynecology</title><addtitle>J Minim Invasive Gynecol</addtitle><description>The objective of our study was to provide a contemporary description of hysterectomy practice and temporal trends in Canada.
A national whole-population retrospective analysis of data from the Canadian Institute for Health Information.
Canada.
All women who underwent hysterectomy for benign indication from April 1, 2007, to March 31, 2017, in Canada.
Hysterectomy.
A total of 369 520 hysterectomies were performed in Canada during the 10-year period, during which the hysterectomy rate decreased from 313 to 243 per 100 000 women. The proportion of abdominal hysterectomies decreased (59.5% to 36.9%), laparoscopic hysterectomies increased (10.8% to 38.6%), and vaginal hysterectomies decreased (29.7% to 24.5%), whereas the national technicity index increased from 40.5% to 63.1% (p <.001, all trends). The median length of stay decreased from 3 (interquartile range 2–4) days to 2 (interquartile range 1–3), and the proportion of patients discharged within 24 hours increased from 2.1% to 7.2%.
In year 2016-17, women aged 40 to 49 years had significantly increased risk of abdominal hysterectomy compared with women undergoing hysterectomy in other age categories (p <.001). Comparing women with menstrual bleeding disorders, women undergoing hysterectomy for endometriosis (adjusted relative risk [aRR] 1.36; 95% confidence interval [CI], 1.28–1.44) and myomas (aRR 2.01; 95% CI, 1.94–2.08) were at increased risk of abdominal hysterectomy, whereas women undergoing hysterectomy for pelvic organ prolapse and pelvic pain (aRR 1.47; 95% CI, 1.41–1.53) were at decreased risk.
Using Ontario as the comparator, Nova Scotia (aRR 1.35; 95% CI, 1.27–1.43), New Brunswick (aRR 1.25; 95% CI, 1.18–1.32]), Manitoba (aRR 1.35; 95% CI, 1.28–1.43), and Newfoundland and Labrador (aRR 1.18; 95% CI, 1.10–1.27) had significantly higher risks of abdominal hysterectomy. In contrast, Saskatchewan (aRR 0.75; 95% CI, 0.74–0.77) and British Columbia (aRR 0.86; 95% CI, 0.85–0.88) had significantly lower risks, whereas Prince Edward Island, Quebec, and Alberta were not significantly different.
The proportion of minimally invasive hysterectomies for benign indication has increased significantly in Canada. The declining use of vaginal approaches and the variation among provinces are of concern and necessitate further study.</description><subject>Abdominal hysterectomy</subject><subject>Hysterectomy</subject><subject>Interprovincial variation</subject><subject>Laparoscopic hysterectomy</subject><subject>Vaginal hysterectomy</subject><issn>1553-4650</issn><issn>1553-4669</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kMtq3DAUQEVoyfsHsihaduPJleWHXLoZhrwgfSwm7VLI0p1GgyxNJc8Eb_PlsTNploULEuLowD2EXDCYMWDV5Xq27uyfWQ45m8E0cECOWVnyrKiq5sP7vYQjcpLSGoDXANUhOeK8qKu6hGPyvET96K22_UCtpwvllVFf6Jx-V70N_skapL8fg8PsZ9hs3esjnXvlhmQTDSu6xG4TonJ0GdGbRJU39JeKdk-Oym_W2045N9A7v1PJ7pDeDqnHiLoPncV0Rj6ulEt4_naekofrq-XiNrv_cXO3mN9nugDoM6Fbg62BkhetEKZhVc6Qc-RMaMNUwQ02pVgZlivDhIJGN6oRdd3U2kCrgJ-Sz3vvJoa_W0y97GzS6JzyGLZJ5oWAvKpFlY9ovkd1DClFXMlNHJeIg2Qgp_ZyLaf2cmovYZrJ_-nNv207NO9f_sUega97AMctdxajTNqi12jsFEOaYP_nfwFkZJdM</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Chen, Innie</creator><creator>Mallick, Ranjeeta</creator><creator>Allaire, Catherine</creator><creator>Bajzak, Krisztina I.</creator><creator>Belland, Liane M.</creator><creator>Bougie, Olga</creator><creator>Cassell, Krista A.</creator><creator>Choudhry, Abdul J.</creator><creator>Cundiff, Geoffrey W.</creator><creator>Kroft, Jamie</creator><creator>Leyland, Nicholas A.</creator><creator>Maheux-Lacroix, Sarah</creator><creator>Rajakumar, Chandrew</creator><creator>Randle, Elizabeth</creator><creator>Robertson, Deborah</creator><creator>Thiel, John A.</creator><creator>Tulandi, Togas</creator><creator>Yong, Paul J.</creator><creator>Laberge, Philippe Y.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202105</creationdate><title>Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies</title><author>Chen, Innie ; Mallick, Ranjeeta ; Allaire, Catherine ; Bajzak, Krisztina I. ; Belland, Liane M. ; Bougie, Olga ; Cassell, Krista A. ; Choudhry, Abdul J. ; Cundiff, Geoffrey W. ; Kroft, Jamie ; Leyland, Nicholas A. ; Maheux-Lacroix, Sarah ; Rajakumar, Chandrew ; Randle, Elizabeth ; Robertson, Deborah ; Thiel, John A. ; Tulandi, Togas ; Yong, Paul J. ; Laberge, Philippe Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-8cbdebd0534b88d91621e33e318cd1a43de958fd12ad18a09c9a987797cd0ba03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdominal hysterectomy</topic><topic>Hysterectomy</topic><topic>Interprovincial variation</topic><topic>Laparoscopic hysterectomy</topic><topic>Vaginal hysterectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Innie</creatorcontrib><creatorcontrib>Mallick, Ranjeeta</creatorcontrib><creatorcontrib>Allaire, Catherine</creatorcontrib><creatorcontrib>Bajzak, Krisztina I.</creatorcontrib><creatorcontrib>Belland, Liane M.</creatorcontrib><creatorcontrib>Bougie, Olga</creatorcontrib><creatorcontrib>Cassell, Krista A.</creatorcontrib><creatorcontrib>Choudhry, Abdul J.</creatorcontrib><creatorcontrib>Cundiff, Geoffrey W.</creatorcontrib><creatorcontrib>Kroft, Jamie</creatorcontrib><creatorcontrib>Leyland, Nicholas A.</creatorcontrib><creatorcontrib>Maheux-Lacroix, Sarah</creatorcontrib><creatorcontrib>Rajakumar, Chandrew</creatorcontrib><creatorcontrib>Randle, Elizabeth</creatorcontrib><creatorcontrib>Robertson, Deborah</creatorcontrib><creatorcontrib>Thiel, John A.</creatorcontrib><creatorcontrib>Tulandi, Togas</creatorcontrib><creatorcontrib>Yong, Paul J.</creatorcontrib><creatorcontrib>Laberge, Philippe Y.</creatorcontrib><creatorcontrib>for the Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration</creatorcontrib><creatorcontrib>Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of minimally invasive gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Innie</au><au>Mallick, Ranjeeta</au><au>Allaire, Catherine</au><au>Bajzak, Krisztina I.</au><au>Belland, Liane M.</au><au>Bougie, Olga</au><au>Cassell, Krista A.</au><au>Choudhry, Abdul J.</au><au>Cundiff, Geoffrey W.</au><au>Kroft, Jamie</au><au>Leyland, Nicholas A.</au><au>Maheux-Lacroix, Sarah</au><au>Rajakumar, Chandrew</au><au>Randle, Elizabeth</au><au>Robertson, Deborah</au><au>Thiel, John A.</au><au>Tulandi, Togas</au><au>Yong, Paul J.</au><au>Laberge, Philippe Y.</au><aucorp>for the Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration</aucorp><aucorp>Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies</atitle><jtitle>Journal of minimally invasive gynecology</jtitle><addtitle>J Minim Invasive Gynecol</addtitle><date>2021-05</date><risdate>2021</risdate><volume>28</volume><issue>5</issue><spage>1041</spage><epage>1050</epage><pages>1041-1050</pages><issn>1553-4650</issn><eissn>1553-4669</eissn><abstract>The objective of our study was to provide a contemporary description of hysterectomy practice and temporal trends in Canada.
A national whole-population retrospective analysis of data from the Canadian Institute for Health Information.
Canada.
All women who underwent hysterectomy for benign indication from April 1, 2007, to March 31, 2017, in Canada.
Hysterectomy.
A total of 369 520 hysterectomies were performed in Canada during the 10-year period, during which the hysterectomy rate decreased from 313 to 243 per 100 000 women. The proportion of abdominal hysterectomies decreased (59.5% to 36.9%), laparoscopic hysterectomies increased (10.8% to 38.6%), and vaginal hysterectomies decreased (29.7% to 24.5%), whereas the national technicity index increased from 40.5% to 63.1% (p <.001, all trends). The median length of stay decreased from 3 (interquartile range 2–4) days to 2 (interquartile range 1–3), and the proportion of patients discharged within 24 hours increased from 2.1% to 7.2%.
In year 2016-17, women aged 40 to 49 years had significantly increased risk of abdominal hysterectomy compared with women undergoing hysterectomy in other age categories (p <.001). Comparing women with menstrual bleeding disorders, women undergoing hysterectomy for endometriosis (adjusted relative risk [aRR] 1.36; 95% confidence interval [CI], 1.28–1.44) and myomas (aRR 2.01; 95% CI, 1.94–2.08) were at increased risk of abdominal hysterectomy, whereas women undergoing hysterectomy for pelvic organ prolapse and pelvic pain (aRR 1.47; 95% CI, 1.41–1.53) were at decreased risk.
Using Ontario as the comparator, Nova Scotia (aRR 1.35; 95% CI, 1.27–1.43), New Brunswick (aRR 1.25; 95% CI, 1.18–1.32]), Manitoba (aRR 1.35; 95% CI, 1.28–1.43), and Newfoundland and Labrador (aRR 1.18; 95% CI, 1.10–1.27) had significantly higher risks of abdominal hysterectomy. In contrast, Saskatchewan (aRR 0.75; 95% CI, 0.74–0.77) and British Columbia (aRR 0.86; 95% CI, 0.85–0.88) had significantly lower risks, whereas Prince Edward Island, Quebec, and Alberta were not significantly different.
The proportion of minimally invasive hysterectomies for benign indication has increased significantly in Canada. The declining use of vaginal approaches and the variation among provinces are of concern and necessitate further study.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33476750</pmid><doi>10.1016/j.jmig.2021.01.010</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1553-4650 |
| ispartof | Journal of minimally invasive gynecology, 2021-05, Vol.28 (5), p.1041-1050 |
| issn | 1553-4650 1553-4669 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2480267862 |
| source | Elsevier ScienceDirect Journals Complete |
| subjects | Abdominal hysterectomy Hysterectomy Interprovincial variation Laparoscopic hysterectomy Vaginal hysterectomy |
| title | Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies |
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