Persistent high rates of hysterectomy in Western Australia: a population-based study of 83 000 procedures over 23 years.
BJOG
; 113(7): 804-9, 2006 Jul.
Article
em En
| MEDLINE
| ID: mdl-16827764
ABSTRACT
OBJECTIVE:
To investigate incidence trends and demographic, social and health factors associated with the rate of hysterectomy and morbidity outcomes in Western Australia and compare these with international studies.DESIGN:
Population-based retrospective cohort study.SETTING:
All hospitals in Western Australia where hysterectomies were performed from 1981 to 2003. POPULATION All women aged 20 years or older who underwent a hysterectomy.METHODS:
Statistical analysis of record-linked administrative health data. MAIN OUTCOMEMEASURES:
Rates, rate ratios and odds ratios for incidence measures and length of stay in hospital and odds ratios for morbidity measures.RESULTS:
The age-standardised rate of hysterectomy adjusted for the underlying prevalence of hysterectomy decreased 23% from 6.6 per 1000 woman-years (95% CI 6.4-6.9) in 1981 to 4.8 per 1000 woman-years (95% CI 4.6-4.9) in 2003. Lifetime risk of hysterectomy was estimated as 35%. In 2003, 40% of hysterectomies were abdominal. The rate of hysterectomy to treat menstrual disorders fell from 4 per 1000 woman-years in 1981 to 1 per 1000 woman-years in 1993 and has since stabilised. Low socio-economic status, having only public health insurance, nonindigenous status and living in rural or remote areas were associated with increased risk of having a hysterectomy for menstrual disorders. Indigenous women had higher rates of hysterectomy to treat gynaecological cancers compared with nonindigenous women, particularly in rural areas. The odds of a serious complication were 20% lower for vaginal hysterectomies compared with abdominal procedures.CONCLUSION:
Western Australia has one of the highest hysterectomy rates in the world, although proportionally, significantly fewer abdominal hysterectomies are performed than in most countries.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Histerectomia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
País/Região como assunto:
Oceania
Idioma:
En
Revista:
BJOG
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Austrália