Journal of minimally invasive gynecology · 2023
Relevance of Uterine Weight for Predicting Surgical Complications in Minimally Invasive Benign Hysterectomy.
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Mouro Steven, Hamed Jenna L Carter, Whiteside James L, Tumin Dmitry
Аннотация
STUDY OBJECTIVES: To describe the uterine weight threshold for increasing risk of complications after a laparoscopic hysterectomy using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.
DESIGN: Cross-sectional analysis using the American College of Surgeons NSQIP database from 2016 to 2021.
SETTING: American College of Surgeons NSQIP database.
PATIENTS: Patients undergoing minimally invasive hysterectomy for benign indications (N = 64 289).
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Uterine weight was entered in grams and 30-day complications were abstracted from patient charts. In the analytic sample, median uterine weight was 135 grams (interquartile range, 90-215) and 6% of patients (n = 4085) experienced complications. Uterine weight performed very poorly in predicting complications on bivariate analysis (area under the receiver operating characteristics curve, 0.53; 95% confidence interval, 0.53-0.54). On multivariable analysis, a uterine weight cutoff of 163 grams was associated with higher odds of complications (odds ratio, 1.11; 95% confidence interval, 1.03-1.19; p = .003), but this threshold achieved only a 43% sensitivity and 62% specificity for predicting complications.
CONCLUSIONS: Uterine weight alone possessed negligible utility for predicting the risk of perioperative complications in minimally invasive hysterectomy.
DESIGN: Cross-sectional analysis using the American College of Surgeons NSQIP database from 2016 to 2021.
SETTING: American College of Surgeons NSQIP database.
PATIENTS: Patients undergoing minimally invasive hysterectomy for benign indications (N = 64 289).
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Uterine weight was entered in grams and 30-day complications were abstracted from patient charts. In the analytic sample, median uterine weight was 135 grams (interquartile range, 90-215) and 6% of patients (n = 4085) experienced complications. Uterine weight performed very poorly in predicting complications on bivariate analysis (area under the receiver operating characteristics curve, 0.53; 95% confidence interval, 0.53-0.54). On multivariable analysis, a uterine weight cutoff of 163 grams was associated with higher odds of complications (odds ratio, 1.11; 95% confidence interval, 1.03-1.19; p = .003), but this threshold achieved only a 43% sensitivity and 62% specificity for predicting complications.
CONCLUSIONS: Uterine weight alone possessed negligible utility for predicting the risk of perioperative complications in minimally invasive hysterectomy.