Trends in the safety of inpatient hysterectomy for benign conditions in California, 1991-2004.
OBJECTIVE
To assess the utilization rates of and complications associated with inpatient hysterectomy in California between 1991 and 2004.


METHODS
We used the California Patient Discharge Database to analyze International Classification of Diseases, 9th Revision, Clinical Modification diagnostic and procedure codes for 649,758 women undergoing inpatient hysterectomy in California between 1991 and 2004 using multiple logistic regression models.


RESULTS
Between 1991 and 2004, the incidence of any type of inpatient hysterectomy for benign gynecologic conditions declined 17.6%. The rates of laparoscopically assisted vaginal hysterectomy and subtotal hysterectomy increased substantially. The year of hysterectomy was a factor associated with both medical and surgical complications; the odds of inpatient complications between 1991 and 2004 steadily declined.


CONCLUSIONS
In California between 1991 and 2004, the incidence of inpatient hysterectomy for benign gynecological conditions and the adjusted odds of complications declined substantially. Changes in practice and shorter hospital stays may have affected the changes in inpatient hysterectomy rates and associated inpatient complications.
Smith
Lloyd H
LH
Department of Obstetrics and Gynecology, University of California, Davis, School of Medicine, Sacramento, California, USA. lhsmith@ucdavis.edu
Waetjen
L Elaine
LE
Paik
Clara K
CK
Xing
Guibo
G