title: Effect of socioeconomic position on patient outcome after hysterectomy.
abstract: OBJECTIVE
  To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship.
  
  
  METHODS
  Register-based cohort study.
  
  
  METHODS
  The study included nearly all Danish women (n = 22 150) registered with a benign elective hysterectomy in the Danish Hysterectomy Database in 2004-2008.
  
  
  METHODS
  Data were analyzed using logistic regression models estimating the odds ratio with 95% confidence intervals.
  
  
  METHODS
  Complications following hysterectomy.
  
  
  RESULTS
  Seventeen percent of the women experienced complications in relation to the hysterectomy. Women with less than high school education and unemployed women had higher odds of infection, complications and readmission than women with more than high school education and employed women. Furthermore, unemployed women had higher odds of hospitalization >4 days than women in employment. Lifestyle factors (smoking and body mass index) and co-morbidity status seemed to explain most of the social differences. However, an association between women with less than high school education and all complications remained unexplained. Furthermore, differences in lifestyle and co-morbidity status only partially explained the higher odds of infection, complications and hospitalization >4 days for unemployed than employed women.
  
  
  CONCLUSIONS
  Women with a low socioeconomic position have significantly higher odds of complications following hysterectomy compared with women with a high socioeconomic position. Unhealthy lifestyle and presence of co-morbidity in women with low socioeconomic position partially explains the differences in complications.
authors: Research Center for Prevention and Health, Capital Region of Denmark, Glostrup University Hospital, Glostrup, Denmark; Department of Gynecology and Obstetrics, Juliane Marie Center, Rigshospitalet University Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Signe B
authors: SB
authors: Daugbjerg
authors: Giulia
authors: G
authors: Cesaroni
authors: Bent
authors: B
authors: Ottesen
authors: Finn
authors: F
authors: Diderichsen
authors: Merete
authors: M
authors: Osler
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003718:Denmark; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007182:Income; D008019:Life Style; D008875:Middle Aged; D012907:Smoking; D012959:Socioeconomic Factors
keywords: Hysterectomy; epidemiology; registry study; socioeconomic position; surgical complications