Thirty-day postoperative mortality after hysterectomy in women with liver cirrhosis: a Danish population-based cohort study.
BACKGROUND
Women with liver cirrhosis have a higher incidence of hysterectomy than the general population, generally because of abnormal bleeding. They may also have an increased risk of postoperative mortality and morbidity.


METHODS
In the nationwide Danish National Patients Register (NPR) we identified all women diagnosed with liver cirrhosis from 1977 to 1993. From this cohort we selected all women undergoing hysterectomy. A random sample of women without liver cirrhosis undergoing hysterectomy was selected as controls. Outcome was defined as mortality within the first 30 days after discharge. Logistic regression analysis was used to estimate the association between liver cirrhosis and 30-day postoperative mortality, adjusted for age, comorbidity, and type of admission.


RESULTS
Out of 8539 women with liver cirrhosis 105 underwent hysterectomy. We found a 30-day postoperative mortality of 7.6% (95% confidence interval (CI) 2.5-12.7%) and 0.6% (95% CI 0.5-0.7%) in women with and without liver cirrhosis, respectively. The crude odds ratio was 14 (95% CI 6.5-29) and the adjusted odds ratio was 11 (95% CI 4.8-24) for 30-day postoperative mortality in women with liver cirrhosis compared with non-cirrhotic controls.


CONCLUSIONS
Hysterectomy in women with liver cirrhosis is associated with an 11-fold increased risk of death within the first 30 days after discharge.
Nielsen
Iana Lesnikova
IL
Department of Clinical Epidemiology, Aarhus and Aalborg University Hospitals, Vennelyst Boulevard 6, Building 260, 8000 Aarhus C, Denmark.
Thulstrup
Ane Marie
AM
Nielsen
Gunnar Lauge
GL
Larsen
Helle
H
Vilstrup
Hendrik
H
Sørensen
Henrik Toft
HT
D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000401:mortality*; D008103:Liver Cirrhosis / Q000150:complications*; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications; D013997:Time Factors