Factors attributing to the failure of endometrial sampling in women with postmenopausal bleeding.
Acta Obstet Gynecol Scand
; 92(10): 1216-22, 2013 Oct.
Article
en En
| MEDLINE
| ID: mdl-23808392
ABSTRACT
OBJECTIVE:
To determine which doctor- and patient-related factors affect failure of outpatient endometrial sampling in women with postmenopausal bleeding, and to develop a multivariable prediction model to select women with a high probability of failed sampling.DESIGN:
Prospective multicenter cohort study.SETTING:
Three teaching hospitals in the Netherlands. POPULATION Women presenting with postmenopausal bleeding with an indication for endometrial sampling.METHODS:
Multivariable logistic regression was performed to evaluate the impact of doctor's training level and patient's characteristics on failure of sampling. MAIN OUTCOMEMEASURES:
Failure of endometrial sampling, classified as technical failure or insufficient tissue for diagnosis.RESULTS:
In 74 (20.8%) of the 356 included women, sampling technically failed, and in 84 (29.8%) the amount of tissue was insufficient for diagnosis. Nulliparity [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.8-7.9] and advanced age (OR 1.03 per year, 95% CI 1.00-1.06) were associated with technical failure. Advanced age was associated with insufficient sampling (OR 1.04 per year, 95% CI 1.01-1.07), and endometrial thickness >12 mm decreased the chance of insufficient sampling (OR 0.3, 95%CI 0.1-0.8). The prediction model for total failure had an area under the ROC curve of 0.64 (95% CI 0.58-0.70).CONCLUSIONS:
In women with postmenopausal bleeding, the failure rate of endometrial sampling is relatively high and is associated with nulliparity and advanced age. Endometrial thickness >12 mm decreased the chance of failure. A multivariable prediction model for total failure based on patient characteristics has a moderate capacity to discriminate between women at high or low risk of failure.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Hemorragia Uterina
/
Técnicas de Apoyo para la Decisión
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Neoplasias Endometriales
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Posmenopausia
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Endometrio
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Atención Ambulatoria
Tipo de estudio:
Clinical_trials
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Acta Obstet Gynecol Scand
Año:
2013
Tipo del documento:
Article
País de afiliación:
Países Bajos