Nationwide Use of Laparoscopic Hysterectomy Compared With Abdominal and Vaginal Approaches
To examine factors associated with undergoing laparoscopic hysterectomy compared with abdominal hysterectomy or vaginal hysterectomy. This is a cross-sectional analysis of the 2005 Nationwide Inpatient Sample. All women aged 18 years or older who underwent hysterectomy for a benign condition were in...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2009-11, Vol.114 (5), p.1041-1048 |
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| container_title | Obstetrics and gynecology (New York. 1953) |
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| creator | Jacoby, Vanessa L. Autry, Amy Jacobson, Gavin Domush, Robert Nakagawa, Sanae Jacoby, Alison |
| description | To examine factors associated with undergoing laparoscopic hysterectomy compared with abdominal hysterectomy or vaginal hysterectomy.
This is a cross-sectional analysis of the 2005 Nationwide Inpatient Sample. All women aged 18 years or older who underwent hysterectomy for a benign condition were included. Multivariable analyses were used to examine demographic, clinical, and health-system factors associated with each hysterectomy route.
Among 518,828 hysterectomies, 14% were laparoscopic, 64% abdominal, and 22% vaginal. Women older than 35 years had lower rates of laparoscopic than abdominal (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.77-0.94 for age 45-49 years) or vaginal hysterectomy (OR 0.61, 95% CI 0.540.69 for age 45-49 years). The odds of laparoscopic compared with abdominal hysterectomy were higher in the West than in the Northeast (OR 1.77, 95% CI 1.2-2.62). African-American, Latina, and Asian women had 40-50% lower odds of laparoscopic compared with abdominal hysterectomy (P |
| doi_str_mv | 10.1097/AOG.0b013e3181b9d222 |
| format | Article |
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This is a cross-sectional analysis of the 2005 Nationwide Inpatient Sample. All women aged 18 years or older who underwent hysterectomy for a benign condition were included. Multivariable analyses were used to examine demographic, clinical, and health-system factors associated with each hysterectomy route.
Among 518,828 hysterectomies, 14% were laparoscopic, 64% abdominal, and 22% vaginal. Women older than 35 years had lower rates of laparoscopic than abdominal (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.77-0.94 for age 45-49 years) or vaginal hysterectomy (OR 0.61, 95% CI 0.540.69 for age 45-49 years). The odds of laparoscopic compared with abdominal hysterectomy were higher in the West than in the Northeast (OR 1.77, 95% CI 1.2-2.62). African-American, Latina, and Asian women had 40-50% lower odds of laparoscopic compared with abdominal hysterectomy (P<.001). Women with low income, Medicare, Medicaid, or no health insurance were less likely to undergo laparoscopic than either vaginal or abdominal hysterectomy (P<.001). Women with leiomyomas (P<.001) and pelvic infections (P<.001) were less likely to undergo laparoscopic than abdominal hysterectomy. Women with leiomyomas (P<.001), endometriosis (P<.001), or pelvic infections (P<.001) were more likely to have laparoscopic than vaginal hysterectomy. Laparoscopic hysterectomy had the highest mean hospital charges ($18,821, P<.001) and shortest length of stay (1.65 days, P<.001).
In addition to age and clinical diagnosis, nonclinical factors such as race/ethnicity, insurance status, income, and region appear to affect use of laparoscopic hysterectomy compared with abdominal hysterectomy and vaginal hysterectomy.
III.]]></description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0b013e3181b9d222</identifier><identifier>PMID: 20168105</identifier><identifier>CODEN: OBGNAS</identifier><language>eng</language><publisher>Hagerstown, MD: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Age Factors ; Biological and medical sciences ; Cross-Sectional Studies ; Digestive system. Abdomen ; Endoscopy ; Ethnicity ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Hysterectomy - methods ; Hysterectomy - statistics & numerical data ; Hysterectomy, Vaginal - statistics & numerical data ; Income ; Insurance, Health ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy - statistics & numerical data ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the genital tract and mammary gland</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2009-11, Vol.114 (5), p.1041-1048</ispartof><rights>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4823-aaad7ec94f2c8ded1b4c4d0f897fa36a1f10f837f1c35afc4d0b355c7228a7af3</citedby><cites>FETCH-LOGICAL-c4823-aaad7ec94f2c8ded1b4c4d0f897fa36a1f10f837f1c35afc4d0b355c7228a7af3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22081546$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20168105$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacoby, Vanessa L.</creatorcontrib><creatorcontrib>Autry, Amy</creatorcontrib><creatorcontrib>Jacobson, Gavin</creatorcontrib><creatorcontrib>Domush, Robert</creatorcontrib><creatorcontrib>Nakagawa, Sanae</creatorcontrib><creatorcontrib>Jacoby, Alison</creatorcontrib><title>Nationwide Use of Laparoscopic Hysterectomy Compared With Abdominal and Vaginal Approaches</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description><![CDATA[To examine factors associated with undergoing laparoscopic hysterectomy compared with abdominal hysterectomy or vaginal hysterectomy.
This is a cross-sectional analysis of the 2005 Nationwide Inpatient Sample. All women aged 18 years or older who underwent hysterectomy for a benign condition were included. Multivariable analyses were used to examine demographic, clinical, and health-system factors associated with each hysterectomy route.
Among 518,828 hysterectomies, 14% were laparoscopic, 64% abdominal, and 22% vaginal. Women older than 35 years had lower rates of laparoscopic than abdominal (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.77-0.94 for age 45-49 years) or vaginal hysterectomy (OR 0.61, 95% CI 0.540.69 for age 45-49 years). The odds of laparoscopic compared with abdominal hysterectomy were higher in the West than in the Northeast (OR 1.77, 95% CI 1.2-2.62). African-American, Latina, and Asian women had 40-50% lower odds of laparoscopic compared with abdominal hysterectomy (P<.001). Women with low income, Medicare, Medicaid, or no health insurance were less likely to undergo laparoscopic than either vaginal or abdominal hysterectomy (P<.001). Women with leiomyomas (P<.001) and pelvic infections (P<.001) were less likely to undergo laparoscopic than abdominal hysterectomy. Women with leiomyomas (P<.001), endometriosis (P<.001), or pelvic infections (P<.001) were more likely to have laparoscopic than vaginal hysterectomy. Laparoscopic hysterectomy had the highest mean hospital charges ($18,821, P<.001) and shortest length of stay (1.65 days, P<.001).
In addition to age and clinical diagnosis, nonclinical factors such as race/ethnicity, insurance status, income, and region appear to affect use of laparoscopic hysterectomy compared with abdominal hysterectomy and vaginal hysterectomy.
III.]]></description><subject>Adult</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Cross-Sectional Studies</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hysterectomy - methods</subject><subject>Hysterectomy - statistics & numerical data</subject><subject>Hysterectomy, Vaginal - statistics & numerical data</subject><subject>Income</subject><subject>Insurance, Health</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopy - statistics & numerical data</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the genital tract and mammary gland</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1v1DAQhi0EokvhHyCUC-opxV-JnQvSagUt0opeWkBcrIk_GkMSBzvb1f77etulhZ48o_edd0Z-EHpL8CnBjfiwvDg7xS0mzDIiSdsYSukztCBSsJIy9uM5WmBMm1JIzo_Qq5R-YYxJ3bCX6IjmQhJcLdDPrzD7MG69scVVskVwxRomiCHpMHldnO_SbKPVcxh2xSoMWbKm-O7nrli2Jgx-hL6A0RTf4PquXk5TDKA7m16jFw76ZN8c3mN09fnT5eq8XF-cfVkt16XmkrISAIywuuGOammsIS3X3GAnG-GA1UAcyQ0TjmhWgdtrLasqLSiVIMCxY_TxPnfatIM12o5zhF5N0Q8QdyqAV_8ro-_UdbhRvOZYUpwDTg4BMfzZ2DSrwSdt-x5GGzZJCcYErmlFspPfO3X-oBSte9hCsNpTUZmKekolj73798KHob8YsuH9wQBJQ-8ijNqnRx_FklS8fty_DX3Gkn73m62NqrPQz53KfPdn4pJi3BCSu3KPnLFbbpiokw</recordid><startdate>20091101</startdate><enddate>20091101</enddate><creator>Jacoby, Vanessa L.</creator><creator>Autry, Amy</creator><creator>Jacobson, Gavin</creator><creator>Domush, Robert</creator><creator>Nakagawa, Sanae</creator><creator>Jacoby, Alison</creator><general>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20091101</creationdate><title>Nationwide Use of Laparoscopic Hysterectomy Compared With Abdominal and Vaginal Approaches</title><author>Jacoby, Vanessa L. ; Autry, Amy ; Jacobson, Gavin ; Domush, Robert ; Nakagawa, Sanae ; Jacoby, Alison</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4823-aaad7ec94f2c8ded1b4c4d0f897fa36a1f10f837f1c35afc4d0b355c7228a7af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Biological and medical sciences</topic><topic>Cross-Sectional Studies</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hysterectomy - methods</topic><topic>Hysterectomy - statistics & numerical data</topic><topic>Hysterectomy, Vaginal - statistics & numerical data</topic><topic>Income</topic><topic>Insurance, Health</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy - statistics & numerical data</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the genital tract and mammary gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jacoby, Vanessa L.</creatorcontrib><creatorcontrib>Autry, Amy</creatorcontrib><creatorcontrib>Jacobson, Gavin</creatorcontrib><creatorcontrib>Domush, Robert</creatorcontrib><creatorcontrib>Nakagawa, Sanae</creatorcontrib><creatorcontrib>Jacoby, Alison</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jacoby, Vanessa L.</au><au>Autry, Amy</au><au>Jacobson, Gavin</au><au>Domush, Robert</au><au>Nakagawa, Sanae</au><au>Jacoby, Alison</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nationwide Use of Laparoscopic Hysterectomy Compared With Abdominal and Vaginal Approaches</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2009-11-01</date><risdate>2009</risdate><volume>114</volume><issue>5</issue><spage>1041</spage><epage>1048</epage><pages>1041-1048</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><coden>OBGNAS</coden><abstract><![CDATA[To examine factors associated with undergoing laparoscopic hysterectomy compared with abdominal hysterectomy or vaginal hysterectomy.
This is a cross-sectional analysis of the 2005 Nationwide Inpatient Sample. All women aged 18 years or older who underwent hysterectomy for a benign condition were included. Multivariable analyses were used to examine demographic, clinical, and health-system factors associated with each hysterectomy route.
Among 518,828 hysterectomies, 14% were laparoscopic, 64% abdominal, and 22% vaginal. Women older than 35 years had lower rates of laparoscopic than abdominal (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.77-0.94 for age 45-49 years) or vaginal hysterectomy (OR 0.61, 95% CI 0.540.69 for age 45-49 years). The odds of laparoscopic compared with abdominal hysterectomy were higher in the West than in the Northeast (OR 1.77, 95% CI 1.2-2.62). African-American, Latina, and Asian women had 40-50% lower odds of laparoscopic compared with abdominal hysterectomy (P<.001). Women with low income, Medicare, Medicaid, or no health insurance were less likely to undergo laparoscopic than either vaginal or abdominal hysterectomy (P<.001). Women with leiomyomas (P<.001) and pelvic infections (P<.001) were less likely to undergo laparoscopic than abdominal hysterectomy. Women with leiomyomas (P<.001), endometriosis (P<.001), or pelvic infections (P<.001) were more likely to have laparoscopic than vaginal hysterectomy. Laparoscopic hysterectomy had the highest mean hospital charges ($18,821, P<.001) and shortest length of stay (1.65 days, P<.001).
In addition to age and clinical diagnosis, nonclinical factors such as race/ethnicity, insurance status, income, and region appear to affect use of laparoscopic hysterectomy compared with abdominal hysterectomy and vaginal hysterectomy.
III.]]></abstract><cop>Hagerstown, MD</cop><pub>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>20168105</pmid><doi>10.1097/AOG.0b013e3181b9d222</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0029-7844 |
| ispartof | Obstetrics and gynecology (New York. 1953), 2009-11, Vol.114 (5), p.1041-1048 |
| issn | 0029-7844 1873-233X |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Age Factors Biological and medical sciences Cross-Sectional Studies Digestive system. Abdomen Endoscopy Ethnicity Female Gynecology. Andrology. Obstetrics Humans Hysterectomy - methods Hysterectomy - statistics & numerical data Hysterectomy, Vaginal - statistics & numerical data Income Insurance, Health Investigative techniques, diagnostic techniques (general aspects) Laparoscopy - statistics & numerical data Medical sciences Middle Aged Multivariate Analysis Odds Ratio Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the genital tract and mammary gland |
| title | Nationwide Use of Laparoscopic Hysterectomy Compared With Abdominal and Vaginal Approaches |
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