Establishment of a national Danish hysterectomy database: preliminary report on the first 13,425 hysterectomies.
OBJECTIVE
To describe the concept and early results from the Danish Hysterectomy Database (DHD).


METHODS
Nationwide prospective cohort.


METHODS
Denmark.


METHODS
All women who had undergone an elective hysterectomy for benign indication carried out in 2004-2006.


METHODS
Structured data are registered prospectively by the surgeons involved in the treatment. Data is reported using the Danish National Patient Registry (LPR) and feedback is provided as clinical indicators with well-defined goals. The DHD concept includes annual plenary meetings, elaboration of national clinical guidelines and parallel causal studies.


METHODS
Completeness, data validation and department-identifiable clinical indicators (surgical volume, method of hysterectomy, use of antibiotic and thromboembolic prophylaxis, postoperative hospitalization and bleeding complications, surgical infections, reoperations, readmissions and death within 30 days postoperatively).


RESULTS
A total of 13,425 hysterectomies were performed in Denmark from 2004 to 2006. In 2005, all gynecological departments in Denmark (n=31) were included in the database collaboration and the national response rate was 99%. Data validity was good in general (82-100% agreement and kappa=0.40-1.00) and data completeness was high (92-100% in 2006). From 2004 to 2006, two clinical guidelines were implemented, the postoperative hospitalization was stable at median 2 days, the rate of postoperative surgical infections was reduced from 4 to 2%, the rate of bleeding complications from 8 to 6%, the reoperation rate from 5 to 4%, and the readmission rate from 7 to 5%.


CONCLUSIONS
Clinical performance indicators, audit meetings and nationwide collaboration are useful in monitoring and improving outcome after hysterectomy on a national level. In addition, the DHD offers scope for causal studies about perioperative management.
Hansen
Charlotte T
CT
Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
Møller
Charlotte
C
Daugbjerg
Signe
S
Utzon
Jan
J
Kehlet
Henrik
H
Ottesen
Bent
B
D016208:Databases, Factual; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged