OBJECTIVE: We sought to develop and evaluate a risk-adjusted perioperative morbidity model for vaginal hysterectomy. STUDY DESIGN: Medical records of women who underwent vaginal hysterectomy during 2004 and 2005 were retrospectively reviewed. Morbidity included hospital readmission, reoperation, and unplanned medical intervention or intensive care unit admission; urinary tract infections were excluded. Multivariate logistic regression identified factors associated with perioperative morbidity (adjusted for urinary tract infection). The resulting model was validated using a random 2006 sample. RESULTS: Of 712 patients, 139 (19.5%) had morbidity associated with congestive heart failure or prior myocardial infarction, perioperative hemoglobin decrease >3.1 g/dL, preoperative hemoglobin <12.0 g/dL, and prior thrombosis (c-index = 0.68). Predicted morbidity was similar to observed rates in the validation sample. CONCLUSION: History of congestive heart failure or myocardial infarction, prior thrombosis, perioperative hemoglobin decrease >3.1 g/dL, or preoperative hemoglobin <12.0 g/dL were associated with increased perioperative complications. Quality improvement efforts should modify these variables to optimize outcomes
Improving quality of care: development of a risk-adjusted perioperative morbidity model for vaginal hysterectomy / C.A. Heisler, G.D. Aletti, A.L. Weaver, L.J. Melton III, W.A. Cliby, J.B. Gebhart. - In: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY. - ISSN 0002-9378. - 202:2(2010), pp. 137.e1-137.e5. ((Intervento presentato al 29. convegno Annual Meeting of the American-Urogynecologic-Society tenutosi a Chicago nel 2008.
|Titolo:||Improving quality of care: development of a risk-adjusted perioperative morbidity model for vaginal hysterectomy|
|Parole Chiave:||perioperative morbidity; risk adjustment; vaginal hysterectomy|
|Settore Scientifico Disciplinare:||Settore MED/40 - Ginecologia e Ostetricia|
|Data di pubblicazione:||2010|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.ajog.2009.06.059|
|Appare nelle tipologie:||01 - Articolo su periodico|