title: Hospital Variation in the Practice of Bilateral Salpingectomy With Ovarian Conservation in 2012.
abstract: OBJECTIVE
  To examine hospital variation in the practice of bilateral salpingectomy with ovarian conservation at the time of benign hysterectomy.
  
  
  METHODS
  We conducted a cross-sectional study using data from the 2012 National Inpatient Sample. We identified hospitalizations for benign, nonobstetric hysterectomy in adult women and excluded women who had elevated risk for ovarian cancer or a subsequent operation of the ovary. Of the remaining sample, we calculated the rate of bilateral salpingectomy with ovarian conservation for each hospital and conducted multivariable regression analysis to identify factors associated with a hospital's practice of this procedure.
  
  
  RESULTS
  There were 63,306 hospitalizations for hysterectomy, and 20,635 were for adult women at low risk for ovarian cancer or subsequent ovarian surgery. Among these low-risk women, only 5.9% (95% confidence interval 5.4-6.5%) received bilateral salpingectomy with ovarian conservation. The rate varied markedly across 744 hospitals in the United States ranging from 0% to 72.2%. At 376 of the hospitals (50.5%), no low-risk women received bilateral salpingectomy with ovarian conservation. When categorizing hospitals into tertiles based on the proportion of their hysterectomies performed laparoscopically, hospitals in the highest tertile were more likely to have low-risk patients undergoing bilateral salpingectomy with ovarian conservation than those in the lowest tertile (adjusted odds ratio 2.343, P=.02). Geographic region, hysterectomy volume, and proportion of white patients were also significantly associated with a hospital's likelihood of having low-risk patients undergoing this procedure.
  
  
  CONCLUSIONS
  The rate of bilateral salpingectomy with ovarian conservation was low in low-risk women undergoing benign hysterectomies. Hospitals varied widely in their practice.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Xiao
authors.initials: X
authors.lastname: Xu
authors.forename: Vrunda Bhavsar
authors.initials: VB
authors.lastname: Desai
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000639:trends*; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D059351:Organ Sparing Treatments / Q000379:methods*; D010053:Ovary; D010818:Practice Patterns, Physicians'; D012044:Regression Analysis; D058994:Salpingectomy / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome; D014481:United States