WEIGHT-BASED OPERATIVE OUTCOMES OF PATIENTS REQUIRING ABDOMINAL HYSTERECTOMY

C.S. Carroll T.C. Austin, C. Cesare, W. May, B.D. Cowan, G.R. Meeks

University of Mississippi, Jackson, MS

OBJECTIVE: To compare operative outcomes of patients, requiring abdominal hysterectomy, stratified by BMI.  
MATERIALS AND METHODS: A Retrospective review of 342 patients who had abdominal hysterectomy between June 2001 and January 2003 at University Medical Center.  Operative outcomes were stratified by Body Mass Index (BMI): <25, 25-35, and >35. ANOVA or Kruskal-Wallis test were used to assess differences followed by a Bonferroni adjustment when significant was p<0.05.
RESULTS: Patient characteristics that were statistically significant included age, diabetes mellitus (DM) and hypertension (BP) in the BMI >35 group.  No difference in blood loss, transfusion, abscess, fever, or ileus was noted.  A trend toward increased operative time, wound infection, readmission and length of stay (LOS) was seen with increasing BMI.

TABLE

BMI	<25 (n=71)	25-35 (n=166)	>35 (n=105)	All (n=342)	p-value
Age	40.3 + 8.1	44.1 + 11.7	43.7 + 10.5	43.7 + 10.8	0.006
BP	22.5%	31.3%	50.5%	35.4%	<0.001
DM	0.0%	7.8%	23.8%	11.1%	<0.001
Time	100	105	116	108	0.071
Wound	0.0%	1.8%	4.8%	2.3%	0.100
Readmit	6.5%	9.0%	12.4%	9.9%	0.599
LOS	3	3	3.5	3	0.065

CONCLUSION: Increasing BMI is significantly correlated with age, diabetes, and hypertension.  A trend is seen toward increased operative time, wound infection, readmission and length of stay. Since BMI is a characteristic not easily modified, these findings may be helpful in counseling patients about risks of surgery.

Key Words: hysterectomy, obesity, body mass index, outcomes

Disclosure - Speakers Bureau: C.S. Carroll, Pfizer; B.D. Cowan, Wyeth; G.R. Meeks, Wyeth.