Trends in Complications Among Benign Hysterectomy Patients in Relation to BMI

Study Objective To evaluate complication rates and length of stay over time in relation to BMI to assess for improvements in care given the increasing need to take care of obese women. Design Retrospective cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Patients or Participants Strict criteria were used to include planned benign hysterectomies without confounding concomitant procedures from 2010 to 2018. Interventions Chi-squared analysis was used to analyze the relationship between complications (wound, length of stay, readmission, etc) and time stratified by BMI categories using CDC criteria and type of hysterectomy (abdominal, laparoscopic, or vaginal). Measurements and Main Results 204,111 hysterectomies met inclusion criteria. Overall length of stay decreased overtime from 1.7 days in 2010-2011 to 1.4 days in 2017-2018 (p 40 undergoing abdominal hysterectomy who had a decrease in overall complication rate from 16.5% in 2010-210 to 12.5% in 2017-2018 (p=0.01). Prolonged length of stay (greater than 2 days) decreased overtime for normal weight, overweight, and Class 1-3 obese women specifically for abdominal and laparoscopic hysterectomies (p Conclusion Irrespective of hysterectomy type and BMI, length of stay is decreasing without differences in readmission rates. Overall, complications rates do not demonstrate significant change overtime. Further analysis is required to determine if this trend will continue and how outcomes can be improved for obese patients.