HYSTERECTOMY AND RACE

Objective: To investigate black-white differences in factors related t o hysterectomy. Methods: Discharge summary data were analyzed for 53,1 59 hysterectomies that occurred in Maryland from 1986-1991. Results: T he average annual age-adjusted hysterectomy rate was higher for black women (49.5 per 10,000) than for white women (41.2 per 10,000). For 65 .4% of the hysterectomies in black women, the principal diagnosis was uterine fibroids, compared to 28.5% for white women. Logistic regressi on was used to measure the effect of race on complications, length of stay, and mortality after adjustment for a variety of factors includin g age, comorbidities, diagnosis, route (abdominal, vaginal, or subtota l), hospital characteristics, and source of payment. In comparison to white women, black women having hysterectomy were found to have an inc reased risk of one or more complications of surgical or medical care ( odds ratio 1.4, 95% confidence interval [CI] 1.3-1.5), a length of sta y of more than 10 days (odds ratio 2.7, 95% CI 2.5-3.1), and in-hospit al mortality (odds ratio 3.1, 95% CI 2.0-4.8). Conclusions: In a study of more than 53,000 hysterectomies, black women were more than twice as likely to have a diagnosis of uterine fibroids as white women, were more likely to have complications, had a longer hospitalization, and had more than three times the in-hospital mortality rate.