Patient and Surgery Characteristics of Inpatient Hysterectomies Among Transgender Individuals.
Patient and Surgery Characteristics of Inpatient Hysterectomies Among Transgender Individuals.
复制标题
变性个体住院子宫切除术的患者和手术特征。
DOI：
10.1089/lgbt.2022.0388
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发表时间：
2023
期刊：
影响因子：
4.8
通讯作者：
Gray,BeverlyA
中科院分区：
文献类型：
--
作者：
Colman,DrewE;Beltran,TheoG;Weber,JeremyM;Erkanli,Alaattin;Robinson,WhitneyR;Myers,EvanR;Gray,BeverlyA
目的：本研究的目的是根据适应症评估住院子宫切除和双侧输卵管卵巢切除术的基于人群的比率，并根据适应症、年份、患者年龄和医院位置评估手术患者的特征。方法：我们使用来自全国住院患者样本的2016和2017年的横断面数据来估计年龄在18-54岁、以性别肯定护理(GAC)为主要适应症的个人的子宫切除率与其他适应症的比较。结果：2016年和2017年，GAC患者的基于人群的子宫切除率分别为0.05(95%可信区间[ = ]0.02~0.09)和0.09(95%CI = 0.03~0.15)。相比之下，2016年和2017年的肌瘤发病率分别为每10万人85.76人和73.25人。在子宫切除的背景下，GAC组的双侧输卵管卵巢切除术的比率(86.4%)高于对照组(所有其他良性适应症的22.7%-44.1%，癌症的77.4%)。与其他适应症相比，GAC患者的子宫全切率更高(63.6%)，没有一例是通过阴道完成的，而对照组为0.7%-9.8%。结论：2017年GAC的全子宫切除率高于2016年，低于其他子宫切除指征。相伴的双侧输卵管卵巢切除的比率在GAC中比在类似年龄的其他指征中更普遍。GAC组的患者倾向于年轻，有保险，大多数手术发生在东北(45.5%)和西部(36.4%)。
Purpose:The purpose of this study is to estimate population-based rates of inpatient hysterectomy and accompanying bilateral salpingo-oophorectomy by indication and evaluate surgical patient characteristics by indication, year, patient age, and hospital location.Methods:We used 2016 and 2017 cross-sectional data from the Nationwide Inpatient Sample to estimate the hysterectomy rate for individuals aged 18–54 years with a primary indication for gender-affirming care (GAC) compared to other indications. Outcome measures were population-based rates for inpatient hysterectomy and bilateral salpingo-oophorectomy by indication.Results:The population-based rate of inpatient hysterectomy for GAC per 100,000 was 0.05 (95% confidence interval [CI] = 0.02–0.09) in 2016 and 0.09 (95% CI = 0.03–0.15) in 2017. For comparison, the rates per 100,000 for fibroids were 85.76 in 2016 and 73.25 in 2017. Rates of bilateral salpingo-oophorectomy in the setting of hysterectomy were higher in the GAC group (86.4%) than in comparison groups (22.7%–44.1% for all other benign indications, 77.4% for cancer) across all age ranges. A higher rate of hysterectomies performed for GAC was done laparoscopically or robotically (63.6%) than other indications, and none was done vaginally, as opposed to comparison groups (0.7%–9.8%).Conclusion:The population-based rate for GAC was higher in 2017 compared to 2016 and low compared to other hysterectomy indications. Rates of concomitant bilateral salpingo-oophorectomy were more prevalent for GAC than for other indications at similar ages. The patients in the GAC group tended to be younger, insured, and most procedures occurred in the Northeast (45.5%) and West (36.4%).