All-cause 30-day mortality associated with hysterectomy in Sweden from 2015 to 2021 using data from the Swedish perioperative register

Abstract

Objective: Hysterectomy is one of the most common gynaecological procedures. All-cause mortality within 30 days is an important indicator of care quality.The primary objectives of this quality project were to study all-cause 30-day mortality following hysterectomy in Sweden and the impact of age, ASA class, and malignant indication on outcomes. Population and methods: All hysterectomy procedures documented in the Swedish Perioperative Register (SPOR) were included from 2015 to 01-01 until 2021-12-31. Patient demographics and perioperative observations were collected and analysed. Main outcome measure: All-cause 30-day mortality. Results: The study cohort consisted of 25,391 patients with a mean age of 55.0 ± 13.8, and 54 % of patients were ASA I-II. All-cause 30-day mortality was low: only 1 patient died within the first 24 h, and 23 deaths were noted within 30 days among 25,391 procedures studied; equal to a perioperative mortality rate (POMR) 0.09 %. Higher age, higher ASA class, malignant indication, and combined general and neuraxial anaesthesia increased numerical POMR. Elderly (>65-years) and ASA III-IV were associated with significant increased un- and adjusted Odds Ratio for death within 30-days at 4.3 (95%CI 1.3–14.3, p = 0.02) and 15.3 (95%CI 4.8–84.4, p = 0.001) respectively. Conclusions: All-cause 30-day mortality associated with hysterectomy in Sweden during recent years is low with a POMR of 0.09 %. Higher age and more pronounced higher ASA class increased the odds ratio for all-cause 30-day mortality. Further efforts to optimise the perioperative care of elderly and frail patients are important.

Keywords

• Hysterectomy
• Age
• ASA physical status
• Open and laparoscopic
• Anaesthesia duration and early recovery
• Perioperative mortality rate (POMR)