ArticleJournal of minimally invasive gynecology2022
Development of a Preoperative Clinical Risk Assessment Tool for Postoperative Complications After Hysterectomy.
Article in Journal of minimally invasive gynecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Malnutrition predicts severe complications but not survival in laryngeal cancer surgery: a propensity-matched analysis.Frontiers in nutrition · 2026Article
- Construction and validation of nomogram to predict surgical site infection after hysterectomy: a retrospective study.Scientific reports · 2024Article
- Risk Assessment Model for Complications in Minimally Invasive Hysterectomy: A Pilot Study.International journal of environmental research and public health · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
STUDY
objectiveTo develop a preoperative risk assessment tool that quantifies the risk of postoperative complications within 30 days of hysterectomy.
designRetrospective analysis.
settingMichigan Surgical Quality Collaborative hospitals. PATIENTS: Women who underwent hysterectomy for gynecologic indications.
interventionsDevelopment of a nomogram to create a clinical risk assessment tool. MEASUREMENTS AND MAIN
resultsPostoperative complications within 30 days were the primary outcome. Bivariate analysis was performed comparing women who had a complication and those who did not. The patient registry was randomly divided. A logistic regression model developed and validated from the Collaborative database was externally validated with hysterectomy cases from the National Surgical Quality Improvement Program, and a nomogram was developed to create a clinical risk assessment tool. Of the 41,147 included women, the overall postoperative complication rate was 3.98% (n = 1638). Preoperative factors associated with postoperative complications were sepsis (odds ratio [OR] 7.98; confidence interval [CI], 1.98-32.20), abdominal approach (OR 2.27; 95% CI, 1.70-3.05), dependent functional status (OR 2.20; 95% CI, 1.34-3.62), bleeding disorder (OR 2.10; 95% CI, 1.37-3.21), diabetes with HbA1c ≥9% (OR 1.93; 95% CI, 1.16-3.24), gynecologic cancer (OR 1.86; 95% CI, 1.49-2.31), blood transfusion (OR 1.84; 95% CI, 1.15-2.96), American Society of Anesthesiologists Physical Status Classification System class ≥3 (OR 1.46; 95% CI, 1.24-1.73), government insurance (OR 1.3; 95% CI, 1.40-1.90), and body mass index ≥40 (OR 1.25; 95% CI, 1.04-1.50). Model discrimination was consistent in the derivation, internal validation, and external validation cohorts (C-statistics 0.68, 0.69, 0.68, respectively).
conclusionWe validated a preoperative clinical risk assessment tool to predict postoperative complications within 30 days of hysterectomy. Modifiable risk factors identified were preoperative blood transfusion, poor glycemic control, and open abdominal surgery.
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