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Higher BMI linked to lower risk of hysterectomy reoperation

 

Key clinical point: Women with a greater BMI had a lower risk of needing a reoperation after hysterectomy.

Major finding: Patients with a BMI of 39 kg/m2 less likely to need a reoperation after hysterectomy (aOR, .73; P = .02).

Data source: Retrospective study of 28,487 women who underwent a hysterectomy from 2014 to 2015 from the American College of Surgeons National Surgical Quality Improvement Program database.

Disclosures: The researchers reported having no relevant financial disclosures.


 

AT AAGL 2017

– Women with a greater body mass index (BMI) were less likely to need reoperation after hysterectomy, according to findings presented at the AAGL Global Congress.

“What’s unusual is women who are considered overweight or obese are generally thought to be at higher risk of any complication, including reoperation,” Janelle Moulder, MD, of the department of ob.gyn. at the University of Tennessee, Knoxville, said in an interview prior to the meeting. “We don’t have enough data to say what exactly might be protective. And to see that women who are at normal or below normal BMI were at increased risk makes you pause as to what could potentially put them at risk.”

Dr. Moulder and her colleagues analyzed data on 28,487 women who underwent an abdominal, vaginal, or laparoscopic hysterectomy from 2014 to 2015. The data came from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database.

Patients were excluded if they had cancer, their surgery was not performed by a gynecologist, or their BMI data was missing.

A majority of patients (13,000) had a BMI of 30 kg/m2 or greater.

Compared with patients with a normal BMI of 24 kg/m2, patients with a BMI of 39 kg/m2 had the lowest odds of reoperation (adjusted odds ratio, 0.73; P = .02). Patients with BMIs of 29 kg/m2 and 34 kg/m2 were also at lower odds of reoperation, with adjusted odds ratios of 0.83 (P = .003) and 0.75 (P = .005), respectively.

Patients with a low normal BMI of 18.5 kg/m2 were at a higher risk of reoperation (aOR = 1.33; P = .001).

Researchers were unable to comment on women with a BMI of 45 kg/m2 or greater, due to the limited number of women in this group.

Researchers did not have access to the reason for reoperation, which may have limited the scope of the study.

“The next thing to be evaluated is what is the protective effect of the increasing BMI on reoperation and also look at variables that may put low normal BMI women at risk for reoperation,” Dr. Moulder said.

The researchers reported having no relevant financial disclosures.

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