title: Nationwide trends in the performance of inpatient hysterectomy in the United States.
abstract: OBJECTIVE
  To examine the use of inpatient hysterectomy and explore changes in the use of various routes of hysterectomy and patterns of referral.
  
  
  METHODS
  The Nationwide Inpatient Sample was used to identify all women aged 18 years or older who underwent inpatient hysterectomy between 1998 and 2010. Weighted estimates of national trends were calculated and the number of procedures performed estimated. Trends in hospital volume and across hospital characteristics were examined.
  
  
  RESULTS
  After weighting, we identified a total 7,438,452 women who underwent inpatient hysterectomy between 1998 and 2010. The number of hysterectomies performed annually rose from 543,812 in 1998 to a peak of 681,234 in 2002; it then declined consistently annually and reached 433,621 cases in 2010. Overall, 247,973 (36.4%) fewer hysterectomies were performed in 2010 compared with 2002. From 2002 to 2010 the number of hysterectomies performed for each of the following indications declined: leiomyoma (-47.6%), abnormal bleeding (-28.9%), benign ovarian mass (-63.1%), endometriosis (-65.3%), and pelvic organ prolapse (-39.4%). The median hospital case volume decreased from 83 procedures per year in 2002 to 50 cases per year in 2010 (P<.001).
  
  
  CONCLUSIONS
  The number of inpatient hysterectomies performed in the United States has declined substantially over the past decade. The median number of hysterectomies per hospital has declined likewise by more than 40%.
  
  
  METHODS
  III.
authors: Departments of Obstetrics and Gynecology and Medicine and the Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, and the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors: Jason D
authors: JD
authors: Wright
authors: Thomas J
authors: TJ
authors: Herzog
authors: Jennifer
authors: J
authors: Tsui
authors: Cande V
authors: CV
authors: Ananth
authors: Sharyn N
authors: SN
authors: Lewin
authors: Yu-Shiang
authors: YS
authors: Lu
authors: Alfred I
authors: AI
authors: Neugut
authors: Dawn L
authors: DL
authors: Hershman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006176:Gynecology / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007297:Inpatients / Q000706:statistics & numerical data; D008875:Middle Aged; D014481:United States
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