Smith CG, Davenport DL, Hoffman MR. Characteristics Associated with Prolonged Length of Stay after Myomectomy for Uterine Myomas.
J Minim Invasive Gynecol 2019;
26:1303-1310. [PMID:
30611974 DOI:
10.1016/j.jmig.2018.12.015]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/21/2018] [Accepted: 12/30/2018] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE
To identify factors contributing to prolonged hospitalization for women undergoing myomectomy for uterine myomas.
PATIENTS
Women undergoing myomectomy for uterine myomas during 2014 to 2016 were identified by the Current Procedural Terminology code.
DESIGN
Retrospective population-based analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
SETTING
Data from the American College of Surgeons National Surgical Quality Improvement Project.
INTERVENTIONS
None.
MEASUREMENTS AND MAIN RESULTS
The primary outcome was length of stay longer than the median (1 day). Preoperative, intraoperative, and postoperative variables were examined to determine predictors for prolonged length of stay (LOS). Seven thousand five hundred thirty-one women underwent abdominal or laparoscopic myomectomy for uterine myomas. Nonwhite race (black: odds ratio [OR] = 2.25; 95% confidence interval [CI], 2.01-2.51; Asian: OR = 1.54; 95% CI, 1.27-1.85; other/unknown: OR = 2.82; 95% CI, 2.43-3.27), preoperative hematocrit <38% (OR = 1.38; 95% CI, 1.26-1.52), body mass index ≥30.1 kg/m2 (OR = 1.36; 95% CI, 1.21-1.53), preoperative blood transfusion (OR = 3.70; 95% CI, 2.03-6.74), perioperative blood transfusion (OR = 6.64; 95% CI, 4.76-9.27), removal of ≥5 myomas (OR = 1.47; 95% CI, 1.28-1.70), and operative time >120 minutes (121-150 minutes: OR = 1.42; 95% CI, 1.15-1.77; 151-180 minutes: OR = 1.59; 95% CI, 1.24-2.03; ≥181 minutes: OR = 1.36; 95% CI, 1.10-1.69) predicted prolonged LOS. Laparoscopy protected against prolonged LOS (OR = 0.11; 95% CI, 0.09-0.13).
CONCLUSIONS
Limited potentially modifiable perioperative factors contributing to prolonged LOS for abdominal or laparoscopic myomectomy were identified and suggest areas for targeted interventions.
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