title: Prior hysterectomy and oophorectomy and incident venous thrombosis risk among postmenopausal women: a population-based, case-control study.
abstract: OBJECTIVE
  Hysterectomy and bilateral salpingo-oophorectomy (BSO) are associated with changes in endogenous hormone levels, yet the risk of venous thrombosis (VT) associated with hysterectomy and BSO is incompletely characterized. This study evaluated the risk of incident VT among postmenopausal women associated with combined prior hysterectomy/oophorectomy status and current use of hormone therapy (HT).
  
  
  METHODS
  In a case-control study, we identified incident VT cases (n = 1,623) among postmenopausal Group Health Cooperative enrollees without reproductive cancer, defining their "index date" as their VT diagnosis date (1995-2010). Matched controls had not experienced a prior VT (n = 4,480). Multiple logistic regression models estimated adjusted relative risks for VT associated with combinations of prior hysterectomy/oophorectomy status and HT use at the index date.
  
  
  RESULTS
  Compared with women with an intact uterus who were not using HT, there was no suggestion of greater VT risk in women with prior hysterectomy without BSO, whether they were (adjusted odds ratio [aOR] = 0.80 [95% CI: 0.57, 1.12]) or were not using HT (aOR = 1.09 [95% CI: 0.89, 1.35]). Women with prior hysterectomy and BSO who were using HT were not at a greater VT risk (OR = 1.00 [95% CI: 0.78, 1.27]), but there was evidence of a 25% greater risk associated with prior hysterectomy with BSO and no current HT use (OR = 1.25 [95% CI: 1.05, 1.49]).
  
  
  CONCLUSIONS
  Collectively, these and prior data do not suggest a substantial impact of hysterectomy, with or without BSO, on the risk of VT among postmenopausal women.
authors.affiliation: 1Department of Epidemiology, University of Washington, Seattle, WA 2Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 3Department of Medicine, University of Washington, Seattle, WA 4Group Health Research Institute, Group Health Cooperative, Seattle, WA 5Department of Biostatistics, University of Washington, Seattle, WA 6Division of Angiology and Haemostasis, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland 7Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 8Department of Preventive Medicine, University of California San Diego, La Jolla, CA 9Department of Health Services, University of Washington, Seattle, WA 10Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Harrington
authors.forename: Noel S
authors.initials: NS
authors.lastname: Weiss
authors.forename: Kerri L
authors.initials: KL
authors.lastname: Wiggins
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: Barbara
authors.initials: B
authors.lastname: McKnight
authors.forename: Marc
authors.initials: M
authors.lastname: Blondon
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Woods
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Smith
mesh_terms: D016022:Case-Control Studies; D015984:Causality; D016001:Confidence Intervals; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D010052:Ovariectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D017698:Postmenopause; D012307:Risk Factors; D058994:Salpingectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D020246:Venous Thrombosis / Q000453:epidemiology*