COMPLICATIONS AFTER HYSTERECTOMY - A DANISH POPULATION-BASED STUDY 1978-1983

We studied complications after hysterectomy among all women in the Dan ish population who had a simple hysterectomy in the period 1978 - 81 b ased on data obtained from the Danish National Hospital Registry. Amon g patients, with neither diagnosed cancer nor major co-surgery (n = 23 ,386), we identified all the complications which occurred during hospi tal admission from the time of surgery up to six years from that point . Within 30 days of hysterectomy 2.6% of the patients had been diagnos ed in hospitals as having complications according to our definition. T he corresponding figures at 90 days and two years after the operation were 3.7% and 9.4%. The most frequently observed complications were po st operative wound infections and bleeding, each affecting about 2% of all operated women. Logistic regression and Cox regression were used to identify prognostic indicators of readmission with complications. T he probability of readmission with complications within six years afte r hysterectomy was estimated at 8% among low risk patients. The most p ronounced increase in risk of readmission with complication occurred a mong women who had been admitted to psychiatric or somatic hospitals 0 -12 months before they had their uterus removed (OR in the range 1.59 to 1.83). We discuss the prevailing difficulties of comparing observat ional evidence from different clinical settings reported in the litera ture, and emphasize the importance of developing a coordinated interna tional strategy for non-experimental assessment of medical technology.