Resource use for total and supracervical hysterectomies: results of a randomized trial.
Resource use for total and supracervical hysterectomies: results of a randomized trial.
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全子宫切除术和宫颈上子宫切除术的资源使用：随机试验的结果。
DOI：
10.1097/01.aog.0000124273.76992.73
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发表时间：
2004
影响因子：
7.2
通讯作者：
Washington,AEugene
中科院分区：
文献类型：
--
作者：
Showstack,Jonathan;Kuppermann,Miriam;Lin,Feng;Vittinghoff,Eric;Varner,REdward;SummittJr,RobertL;McNeeley,SGene;Learman,LeeA;Richter,Holly;Hulley,Stephen;Washington,AEugene
目的：子宫切除术是美国最常见的非产科原因的主要外科手术。虽然大多数子宫颈切除术包括切除宫颈，但近年来宫颈上切除术的比例有所增加。为了提供关于两种子宫切除术结局的证据，我们进行了一项全子宫切除术（TAH）或宫颈上子宫切除术（SCH）的随机临床试验（“TOSH”试验）。我们在这里报告的24个月的资源使用的患者在此trial.METHODS：一个随机对照试验进行了3个临床中心，比较120例接受全子宫切除术或经腹子宫切除术的患者所使用的资源。在24个月的随访期内，从医疗和账单记录和患者报告中识别出服务使用情况。结果：在随机化后的前12个月，两个研究组的总体资源使用情况相似（TAH $5，870; SCH $6，018;差异的95%置信区间为− 960，$1，255; P<0.05）。79)而对于整个24个月（TAH 6，448美元; SCH 7，479美元;差异的95%置信区间-533美元，2，616美元; P<. 20）。在探索性多变量分析中，资源使用与基线体重指数大于或等于35 kg/m2显著相关（8，440美元vs 6，398美元，P=. 0001）。02)和严重出血（7，550美元对5，368美元，P=.结论：我们得出结论，在24个月的时间内，全子宫切除术和宫颈上子宫切除术的医疗资源使用是相当的。一个女人的体重和出血模式与随后的资源使用的关联需要进一步investigation.Level的证据：IThe postsurgery使用的医疗保健资源是可比的患者谁接受全子宫切除术和那些谁接受子宫切除术。
OBJECTIVE:Hysterectomy is the most common major surgical procedure performed in the United States for nonobstetric reasons. Although most hysterectomies include removal of the cervix, the rate of supracervical procedures has increased in recent years. To provide evidence about the outcomes of both types of hysterectomy, we conducted a randomized clinical trial of total (TAH) or supracervical (SCH) hysterectomy (the “TOSH” trial). We report here an analysis of 24-month resource use by patients in this trial.METHODS:A randomized controlled trial was performed at 3 clinical centers to compare resources used by 120 patients who received a total or supracervical abdominal hysterectomy. Service use during a 24-month follow-up period was identified from medical and billing records and patient reports. Each service used was assigned a relative value, which was then converted into 2002 US dollars.RESULTS:Overall resource use was similar in the 2 study groups in the first 12 months after randomization (TAH $5,870; SCH $6,018; 95% confidence interval for difference− $960, $1,255; P<. 79) and for the full 24 months (TAH $6,448; SCH $7,479; 95% confidence interval for difference− $533, $2,616; P<. 20). In exploratory multivariable analyses, resource use was significantly associated with baseline body mass index greater than or equal to 35 kg/m 2 ($8,440 versus $6,398, P=. 02) and heavy bleeding ($7,550 versus $5,368, P=. 02).CONCLUSION:We conclude that the use of medical care resources over a 24-month period is comparable for total and supracervical hysterectomy. The association of a woman’s weight and bleeding pattern with subsequent resource use requires further investigation.LEVEL OF EVIDENCE:IThe postsurgery use of medical care resources is comparable for patients who receive a total hysterectomy and those who receive a supracervical hysterectomy.