| Improving quality of care: development of a risk-adjusted perioperative morbidity model for vaginal hysterectomy. | |
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MedLine Citation:
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PMID: 19691949 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to develop and evaluate a risk-adjusted perioperative morbidity model for vaginal hysterectomy. STUDY DESIGN: Medical records of women who underwent vaginal hysterectomy during 2004 and 2005 were retrospectively reviewed. Morbidity included hospital readmission, reoperation, and unplanned medical intervention or intensive care unit admission; urinary tract infections were excluded. Multivariate logistic regression identified factors associated with perioperative morbidity (adjusted for urinary tract infection). The resulting model was validated using a random 2006 sample. RESULTS: Of 712 patients, 139 (19.5%) had morbidity associated with congestive heart failure or prior myocardial infarction, perioperative hemoglobin decrease >3.1 g/dL, preoperative hemoglobin <12.0 g/dL, and prior thrombosis (c-index = 0.68). Predicted morbidity was similar to observed rates in the validation sample. CONCLUSION: History of congestive heart failure or myocardial infarction, prior thrombosis, perioperative hemoglobin decrease >3.1 g/dL, or preoperative hemoglobin <12.0 g/dL were associated with increased perioperative complications. Quality improvement efforts should modify these variables to optimize outcomes. |
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Authors:
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Christine A Heisler; Giovanni D Aletti; Amy L Weaver; L Joseph Melton; William A Cliby; John B Gebhart |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. Date: 2009-08-18 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 202 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-01 Completed Date: 2010-02-19 Revised Date: 2011-12-06 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 137.e1-5 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Heart Failure / complications Hemoglobins / analysis Humans Hysterectomy, Vaginal / adverse effects* Logistic Models Middle Aged Morbidity Myocardial Infarction / complications Quality of Health Care* Retrospective Studies Risk Factors Thrombosis / complications |
| Grant Support | |
ID/Acronym/Agency:
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R01 AR030582-43/AR/NIAMS NIH HHS; RA-30582/RA/ARRA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins |
| Comments/Corrections | |
Comment In:
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Am J Obstet Gynecol. 2010 Feb;202(2):e1-3
[PMID:
20113684
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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