Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
J Minim Invasive Gynecol. 2023 Aug;30(8):627-634. doi: 10.1016/j.jmig.2023.03.024. Epub 2023 Apr 8.
To examine national trends among race and ethnicity and route of benign hysterectomy from 2007 to 2018.
This is a retrospective analysis of the prospective National Surgical Quality Improvement Program cohort program.
This study included data from the National Surgical Quality Improvement Program database including data from the 2014 to 2018 targeted hysterectomy files.
Adult patients undergoing hysterectomy.
None MEASUREMENTS AND MAIN RESULTS: Current Procedural Terminology codes identified women undergoing benign hysterectomy and perioperative data including race and ethnicity were obtained. To determine relative trends in hysterectomy among race and ethnicity cohorts (White, Black, Hispanic), we calculated the proportion of each procedure performed annually within each race and ethnicity group and compared it across groups. From 2007 to 2018, 269 794 hysterectomies were collected (190 154 White, 45 756 Black, and 33 884 Hispanic). From 2007 to 2018, rates of laparoscopic hysterectomy increased in all cohorts (30.2%-71.6% for White, 23.9%-58.5% for Black, 19.9%-64.0% for Hispanic; p <0.01 for all). For each year from 2007 to 2018, the proportion of women undergoing open abdominal hysterectomy remained twice as high in Black Women compared with White women (33.1%-14.4%, p <.01). Data from the 2014 to 2018 targeted files showed Black and Hispanic women undergoing benign hysterectomy were generally younger, had larger uteri, were more likely to be current smokers, have diabetes and/or hypertension, have higher body mass index, and have undergone previous pelvic surgery (p ≤.01 for all).
Compared with White women, Black and Hispanic women are less likely to undergo benign hysterectomy via a minimally invasive approach. Although larger uteri and comorbid conditions may attribute to higher rates of open abdominal hysterectomy, the higher prevalence of abdominal hysterectomy among younger Black and Hispanic women highlights potential racial disparities in women's health and access to care.
从 2007 年到 2018 年，研究种族和民族以及良性子宫切除术途径的全国趋势。
这是一项对前瞻性国家手术质量改进计划队列计划的回顾性分析。
本研究纳入了国家手术质量改进计划数据库的数据，包括 2014 年至 2018 年目标性子宫切除术档案的数据。
接受子宫切除术的成年患者。
无
当前手术程序术语代码确定了接受良性子宫切除术的女性，并获得了围手术期数据，包括种族和民族。为了确定种族和民族队列（白人、黑人、西班牙裔）中子宫切除术的相对趋势，我们计算了每年在每个种族和民族群体中进行的每个手术的比例，并在群体之间进行了比较。从 2007 年到 2018 年，共收集了 269794 例子宫切除术（白人 190154 例，黑人 45756 例，西班牙裔 33884 例）。从 2007 年到 2018 年，所有队列的腹腔镜子宫切除术比例均有所增加（白人 30.2%-71.6%，黑人 23.9%-58.5%，西班牙裔 19.9%-64.0%；所有 p<0.01）。从 2007 年到 2018 年，每年黑人妇女接受开腹子宫切除术的比例仍然是白人妇女的两倍（33.1%-14.4%，p<.01）。2014 年至 2018 年目标档案的数据显示，黑人女性和西班牙裔女性接受良性子宫切除术的年龄普遍较小，子宫较大，更有可能是当前吸烟者，患有糖尿病和/或高血压，体重指数较高，并且接受过以前的盆腔手术（所有 p≤.01）。
与白人女性相比，黑人女性和西班牙裔女性接受微创方法进行良性子宫切除术的可能性较小。虽然较大的子宫和合并症可能导致开腹子宫切除术的比例较高，但年轻的黑人女性和西班牙裔女性中腹部子宫切除术的更高发生率突出了妇女健康和获得护理方面的潜在种族差异。
