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Low Procedure Volume for Many Surgeons Doing Hysterectomies

WEDNESDAY, May 9, 2018 -- A substantial number of surgeons performing hysterectomies have low procedural volumes, according to a study published online May 9 in Obstetrics & Gynecology.

Maria P. Ruiz, D.O., from Columbia University in New York City, and colleagues examined the changes in surgeon and hospital procedural volume for hysterectomy over time and the association between very low surgeon procedural volume and outcomes among all women who underwent hysterectomy in the state of New York from 2000 to 2014 (434,125 patients).

The researchers found that 41 percent of the surgeons (3,197) performing the procedure operated on 1 percent of the patients. For very low-volume surgeons, the overall complication rates were 32.0 percent, compared to 9.9 percent for those treated by other surgeons (P < 0.001; adjusted relative risk, 1.97). Rates of intraoperative, surgical site, and medical complications, as well as transfusion were higher for very low-volume versus higher volume surgeons (P < 0.001 for all). Additionally, compared to higher volume surgeons, patients of very low-volume surgeons had a higher likelihood of prolonged length of stay and excessive hospital charges (P < 0.001 for both). Finally, mortality rates were higher for very low-volume surgeons versus higher volume surgeons (P < 0.001; adjusted relative risk, 2.89).

"A substantial number of surgeons performing hysterectomy are very low-volume surgeons," the authors write.

One author disclosed financial ties to Pfizer, Teva, Otsuka, and United Biosource Corporation.

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Posted: May 2018