Variation in ovarian conservation in women undergoing hysterectomy for benign indications.

摘要: OBJECTIVE Emerging data suggest that oophorectomy at the time of hysterectomy for benign indications may increase long-term morbidity and mortality. We performed a population-based analysis to estimate rates in women undergoing indications. METHODS The Perspective database was used rate ovarian preservation aged 40-64 years who underwent Hierarchical mixed-effects regression models were developed influence patient, procedural, physician, hospital characteristics on conservation. Between-hospital variation also estimated. RESULTS Among 752,045 women, 348,972 (46.4%) bilateral oophorectomy, whereas 403,073 (53.6%) had Stratified by age, conservation 74.3% those younger than 40 age; 62.7% 40-44 40.8% 45-49 25.2% 50-54 25.5% 55-59 31.0% 60-64 age. Younger age more recent year surgery strongest association with observed accounted only 46% total conservation; 54% variability remained unexplained, suggesting large amount intrinsic between-hospital decision perform oophorectomy. CONCLUSION is increasing, particularly among 50 old. Although demographic clinical factors there appears be substantial performance remains unexplained measurable or characteristics. LEVEL OF EVIDENCE II.