Hysterectomy rates in the United States 1990-1997
Hysterectomy rates in the United States 1990-1997
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DOI：
10.1016/s0029-7844(01)01723-9
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发表时间：
2002-02-01
影响因子：
7.2
通讯作者：
Steiner, CA
中科院分区：
文献类型：
--
作者：
Farquhar, CM;Steiner, CA
目的：评估1990- 1997年美国子宫切除率、子宫切除术类型和其他相关因素。方法：对全国出院数据进行描述性统计分析。1990年至1997年，使用了来自医疗保健成本和利用项目的全国住院患者样本的数据（根据美国社区医院20%的分层样本生成全国估计数）。所有接受子宫切除术的女性均使用国际疾病分类第9版、临床修改、程序代码进行识别。结果的措施包括率，子宫切除术的类型，患者的年龄，住院时间，总住院费用，和诊断categorys.RESULTS：子宫切除术的发生率没有显着变化，从1990年至1997年。1990年子宫切除率为每1 000名妇女5.5例，到1997年略有增加，为每1 000名妇女5.6例。子宫切除术的类型发生了变化，到1997年腹腔镜子宫切除术占病例的9.9%，同时腹式子宫切除术的比例下降，但阴式子宫切除术的比例没有实质性变化。所有类型子宫切除术的住院时间缩短，总费用增加。阴式子宫切除术和腹腔镜子宫切除术的住院时间短于腹式子宫切除术。结论：子宫切除术以腹式为主，适应证以子宫肌瘤最常见。采用替代技术控制异常子宫出血，如子宫内膜切除术，对子宫切除率没有影响，腹腔镜方法的使用也很有限。(C)2002年由美国妇产科医师学会。
OBJECTIVE: To assess hysterectomy rates, type of hysterectomy, and other factors associated within the United States from 1990-1997.METHODS: A descriptive statistical analysis of national discharge data was undertaken. Data from the nationwide Inpatient Sample of the Healthcare Cost and Utilization Project (from which national estimates are generated based on a 20% stratified sample of US community hospitals) were used for the years 1990-1997. All women who underwent hysterectomy were identified using International Classification of Diseases, 9th Revision, Clinical Modification, procedure codes. Outcome measures included rate, type of hysterectomy, age of patients, length of stay, total hospital charges, and diagnostic categories.RESULTS: Rates of hysterectomy have not changed significantly over the years from 1990-1997. Rates for hysterectomy in 1990 were 5.5 per 1000 women and increased slightly by 1997 to 5.6 per 1000 women. The type of hysterectomy has changed, with laparoscopic hysterectomy accounting for 9.9% of cases by 1997, with a concomitant decline in abdominal hysterectomy but no substantial change in vaginal hysterectomy rates. Length of stay decreased and total charges increased for all types of hysterectomy. Vaginal hysterectomy and laparoscopic hysterectomy are associated with shorter length of stay than abdominal hysterectomy. Abdominal hysterectomy is e most common procedure (63.0% in 1997).CONCLUSION: The majority of hysterectomies are abdominal, and the most common indication is uterine fibroids. The introduction of alternative techniques for controlling abnormal uterine bleeding such as endometrial ablation has not had an impact on hysterectomy rates, and there has only been a limited uptake of laparoscopic approaches. (C) 2002 by the American College of Obstetricians and Gynecologists.