[Hysterectomy in Denmark. An analysis of postoperative hospitalization, morbidity and readmission].
BACKGROUND
The aim of this study was to demonstrate the incidence of "standard" hysterectomy in Denmark, including surgical route, postoperative hospitalisation, morbidity, mortality, and readmission rate within 30 days.


METHODS
We analysed data from the Danish National Patient Register over a two-year period (1998-2000) on hysterectomies for benign indications, carcinoma in situ cervicis uteri, and cancer corporis uteri stage 1. A stratified sample of 821 discharge résumés was reviewed for detection of complications.


RESULTS
Over the two-year period, 10,171 women had "standard" hysterectomies followed by a median postoperative hospitalisation of four days. In departments performing more than 100 operations per year, the median hospital stay varied from three to 5.5 days. Eighty per cent of the hysterectomies were abdominal, 6% laparoscopically assisted, and 14% vaginal with marked regional variation in the choice of surgical approach. The number of vaginal hysterectomies varied from 0 to 67% in departments with a surgical activity of more than 100 per year. Eight per cent were readmitted within 30 days of the operation and the mortality rate was 0.6@1000. Extrapolation from the random sample to the entire population gives an estimated complication rate of a minimum of 18%.


CONCLUSIONS
"Standard" hysterectomy in Denmark is associated with considerable morbidity and marked regional variation in the choice of surgical approach. The present study emphasises the need for a national hysterectomy database with the possibility of evaluating surgical activity, reducing morbidity rates, and developing homogeneous guidelines.
Møller
Charlotte
C
Center for Evaluering og Medicinsk Teknologivurdering, Islands Brygge 67, postboks 1881, DK-2300 København S.
Kehlet
Henrik
H
Utzon
Jan
J
Ottesen
Bent S
BS
D002278:Carcinoma in Situ / Q000601:surgery; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D012042:Registries; D014594:Uterine Neoplasms / Q000601:surgery