Nationwide Trends in the Performance of Inpatient Hysterectomy in the United States
Nationwide Trends in the Performance of Inpatient Hysterectomy in the United States
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DOI：
10.1097/aog.0b013e318299a6cf
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发表时间：
2013-08-01
影响因子：
7.2
通讯作者：
Hershman, Dawn L.
中科院分区：
文献类型：
--
作者：
Wright, Jason D.;Herzog, Thomas J.;Hershman, Dawn L.
目的：了解住院患者子宫切除术的使用情况，探讨各种子宫切除术途径和转诊方式的变化。方法：全国住院患者样本用于确定1998年至2010年期间接受住院子宫切除术的所有18岁或以上女性。计算了全国趋势的加权估计值，并估计了所进行的手术数量。研究了医院数量的趋势和整个医院的特点。结果：加权后，我们共确定了7,438,452名1998年至2010年间接受住院子宫切除术的妇女。每年接受子宫切除手术的人数由1998年的543,812例上升至2002年的681,234例；然后每年持续下降，2010年达到433,621例。总体而言，与2002年相比，2010年子宫切除术减少了247,973例（36.4%）。从2002年到2010年，针对以下适应症的子宫切除术数量有所下降：平滑肌瘤（247.6%）、异常出血（228.9%）、良性卵巢肿块（263.1%）、子宫内膜异位症（265.3%）和盆腔器官脱垂（239.4%）。医院病例中位数从2002年的83例/年下降到2010年的50例/年
OBJECTIVE: To examine the use of inpatient hysterectomy and explore changes in the use of various routes of hysterectomy and patterns of referral.METHODS: The Nationwide Inpatient Sample was used to identify all women aged 18 years or older who underwent inpatient hysterectomy between 1998 and 2010. Weighted estimates of national trends were calculated and the number of procedures performed estimated. Trends in hospital volume and across hospital characteristics were examined.RESULTS: After weighting, we identified a total 7,438,452 women who underwent inpatient hysterectomy between 1998 and 2010. The number of hysterectomies performed annually rose from 543,812 in 1998 to a peak of 681,234 in 2002; it then declined consistently annually and reached 433,621 cases in 2010. Overall, 247,973 (36.4%) fewer hysterectomies were performed in 2010 compared with 2002. From 2002 to 2010 the number of hysterectomies performed for each of the following indications declined: leiomyoma (247.6%), abnormal bleeding (228.9%), benign ovarian mass (263.1%), endometriosis (265.3%), and pelvic organ prolapse (239.4%). The median hospital case volume decreased from 83 procedures per year in 2002 to 50 cases per year in 2010 (P