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Influence of the modifiable life-style factors body mass index and smoking on the outcome of hysterectomy
Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
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2016 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 1, 65-73 p.Article in journal (Refereed) PublishedText
Abstract [en]

Introduction

The aim of this study was to study the impact of body mass index (BMI) and smoking on the outcome of hysterectomy and whether effects of these factors vary between abdominal, laparoscopic and vaginal hysterectomy.

Material and methods

Pre-, per- and postoperative (8 weeks) data were retrieved from the Swedish National Register for Gynecological Surgery on 28 537 hysterectomies performed because of a benign indication between 2004 and 2013. Multivariable logistic regression analyses were used to identify independent factors affecting the rate of complications, presented as adjusted odds ratios (adjOR) with 95% confidence intervals (CI).

Results

Overweight and obesity had the strongest impact on complications in the abdominal hysterectomy group. In women with a BMI 30 an increased adjOR could be seen for bleeding >1000 mL (2.90; 95% CI 2.23-3.77), peroperative complications (1.54; 95% CI 1.26-1.88), operation time >120 min (2.67; 95% CI 2.33-3.03), postoperative complications (1.21; 95% CI 1.08-1.34) and postoperative infections (1.73; 95% CI 1.50-1.99). With vaginal hysterectomy, the effect of BMI 30 could be seen in relation to excessive bleeding >500 mL (1.63; 95% CI 1.22-2.17) and operative time >120 min (2.00; 95% CI 1.60-2.50). With laparoscopic hysterectomy (LH), a BMI 30 had a higher adjOR for prolonged surgery (1.71; 95% CI 1.30-2.26). Smokers had an increased risk of postoperative infection in the abdominal hysterectomy (1.23; 95% CI 1.07-1.40) and vaginal hysterectomy groups (1.21; 95% CI 1.02-1.43) but not in the LH group.

Conclusions

Body mass index and smoking had a negative effect with all hysterectomy approaches but to a lesser extent in vaginal and laparoscopic hysterectomies. This should be taken into consideration in advance of surgery to improve outcome.

Place, publisher, year, edition, pages
2016. Vol. 95, no 1, 65-73 p.
Keyword [en]
Abdominal hysterectomy, vaginal hysterectomy, laparoscopic hysterectomy, complications, body mass index, smoking
National Category
Obstetrics, Gynecology and Reproductive Medicine Mathematics
Identifiers
URN: urn:nbn:se:umu:diva-114572DOI: 10.1111/aogs.12794ISI: 000367341200010PubMedID: 26459279OAI: oai:DiVA.org:umu-114572DiVA: diva2:902528
Available from: 2016-02-11 Created: 2016-01-25 Last updated: 2016-02-15Bibliographically approved

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Lindkvist, Håkan
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Department of Mathematics and Mathematical Statistics
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