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. 2013 Aug;122(2 Pt 1):233-241.
doi: 10.1097/AOG.0b013e318299a6cf.

Nationwide trends in the performance of inpatient hysterectomy in the United States

Jason D Wright  1 , Thomas J Herzog, Jennifer Tsui, Cande V Ananth, Sharyn N Lewin, Yu-Shiang Lu, Alfred I Neugut, Dawn L Hershman
Affiliations

Nationwide trends in the performance of inpatient hysterectomy in the United States

Jason D Wright et al. Obstet Gynecol. 2013 Aug.

Abstract

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 (-47.6%), abnormal bleeding (-28.9%), benign ovarian mass (-63.1%), endometriosis (-65.3%), and pelvic organ prolapse (-39.4%). The median hospital case volume decreased from 83 procedures per year in 2002 to 50 cases per year in 2010 (P<.001).

Conclusion: The number of inpatient hysterectomies performed in the United States has declined substantially over the past decade. The median number of hysterectomies per hospital has declined likewise by more than 40%.

Level of evidence: III.

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Conflict of interest statement

Financial Disclosure

The authors did not report any potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Number of hysterectomies performed stratified by year of the procedure. Wright. Trends in Use of Inpatient Hysterectomy. Obstet Gynecol 2013.
Fig. 2
Fig. 2
A. Hysterectomies (%) performed via each surgical route by year of procedure. B. Procedures (n) performed each year stratified by indication for surgery. Wright. Trends in Use of Inpatient Hysterectomy. Obstet Gynecol 2013.
Fig. 3
Fig. 3
A. Hysterectomies (n) performed each year stratified by hospital teaching status. B. Procedures performed each year stratified by hospital location. Wright. Trends in Use of Inpatient Hysterectomy. Obstet Gynecol 2013.
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