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The primary objective was to identify factors contributing to prolonged hospitalization for women undergoing myomectomy for uterine fibroids. DESIGN (CANADIAN TASK FORCE CLASSIFICATION II-2): Retrospective population-based analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
Women undergoing myomectomy for uterine fibroids during 2014-2016 were identified by CPT code.
Data from ACS-NSQIP INTERVENTIONS: None.
Primary outcome was length of stay > the median (1 day). Preoperative, intraoperative, and postoperative variables were examined to determine predictors for prolonged LOS. Seven thousand five hundred and thirty-one women underwent abdominal or laparoscopic myomectomy for uterine fibroids. Non-white race (Black, OR 2.25, CI 2.01-2.51; Asian, OR 1.54, CI 1.27-1.85; Other/Unknown, OR 2.82, CI 2.43-3.27), preoperative hematocrit < 38% (OR 1.38, CI 1.26-1.52), BMI ≥ 30.1 kg/m2 (OR 1.36, CI 1.21-1.53), preoperative blood transfusion (OR 3.70, CI 2.03-6.74), perioperative blood transfusion (OR 6.64, CI 4.76-9.27), removal of ≥ 5 fibroids (OR 1.47, CI 1.28-1.70), and operative time > 120 minutes (121-150, OR 1.42, CI 1.15-1.77; 151-180, OR 1.59, CI 1.24-2.03; ≥ 181, OR 1.36, CI 1.10-1.69) predicted prolonged LOS. Laparoscopy protected against prolonged LOS (OR 0.11, CI 0.09-0.13).
Limited potentially modifiable perioperative factors contributing to prolonged LOS for abdominal or laparoscopic myomectomy were identified and suggest areas for targeted interventions.
Copyright © 2019. Published by Elsevier Inc.
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