| Factor | Hysterectomy | |||||
|---|---|---|---|---|---|---|
| Vaginal* | Laparoscopic* | Minimally invasive* | ||||
| OR (95% CI) | Adjusted OR (95% CI) | OR (95% CI) | Adjusted OR (95% CI) | OR (95% CI) | Adjusted OR (95% CI) | |
| Demographic or patient | ||||||
| Year of procedure | 0.98 (0.93–1.04) | 1.12 (1.02–1.22) | 1.25 (1.18–1.32) | 1.32 (1.24–1.40) | 1.10 (1.05–1.15) | 1.25 (1.19–1.32) |
| Age, yr | ||||||
| ≤ 29 | 1.77 (0.55–5.69) | 1.11 (0.26–4.69) | 8.57 (4.20–17.5) | 4.59 (2.10–10.0) | 6.11 (3.03–12.3) | 3.77 (1.78–7.95) |
| 30–39 | 1.49 (1.12–1.99) | 0.87 (0.59–1.31) | 1.89 (1.52–2.37) | 1.30 (1.01–1.68) | 1.75 (1.43–2.14) | 1.24 (0.98–1.56) |
| 40–49 | Reference | Reference | Reference | Reference | Reference | Reference |
| 50–59 | 1.98 (1.64–2.41) | 1.25 (0.89–1.75) | 0.80 (0.66–0.97) | 0.77 (0.61–0.96) | 1.23 (1.05–1.43) | 0.89 (0.73–1.09) |
| 60–69 | 9.25 (7.22–11.8) | 1.75 (1.05–2.92) | 1.20 (0.87–1.66) | 0.66 (0.44–0.98) | 4.12 (3.29–5.16) | 0.91 (0.65–1.27) |
| ≥ 70 | 17.3 (12.6–23.9) | 1.74 (0.94–3.22) | 0.72 (0.41–1.27) | 0.33 (0.17–0.61) | 6.75 (4.97–9.15) | 0.78 (0.51–1.21) |
| Rural residence | 1.60 (1.19–2.15) | 1.12 (0.63–2.01) | 1.65 (1.21–2.24) | 1.89 (1.28–2.78) | 1.62 (1.26–2.09) | 1.62 (1.14–2.29) |
| Socioeconomic quintile† | ||||||
| 1 (lowest) | 0.58 (0.47–0.71) | 0.81 (0.56–1.16) | 0.58 (0.47–0.72) | 0.58 (0.46–0.74) | 0.58 (0.49–0.69) | 0.62 (0.50–0.77) |
| 2 | 0.61 (0.46–0.79) | 0.76 (0.46–1.24) | 0.66 (0.50–0.87) | 0.58 (0.43–0.80) | 0.63 (0.51–0.79) | 0.58 (0.43–0.77) |
| 3 (median) | 0.91 (0.73–1.13) | 1.07 (0.70–1.64) | 0.62 (0.49–0.78) | 0.67 (0.50–0.89) | 0.77 (0.64–0.92) | 0.74 (0.58–0.96) |
| 4 | 0.81 (0.64–1.03) | 0.87 (0.58–1.29) | 0.93 (0.73–1.18) | 0.86 (0.66–1.11) | 0.86 (0.71–1.05) | 0.86 (0.68–1.09) |
| 5 (highest) | Reference | Reference | Reference | Reference | Reference | Reference |
| Indication (main diagnosis) | ||||||
| Fibroids | 0.23 (0.18–0.3) | 0.24 (0.18–0.33) | 0.37 (0.3–0.45) | 0.37 (0.29–0.46) | 0.31 (0.26–0.37) | 0.31 (0.26–0.38) |
| Menstrual disorders | Reference | Reference | Reference | Reference | Reference | Reference |
| Prolapse | 33.9 (25.1–45.7) | 34.4 (21.1–56.3) | 1.76 (1.24–2.50) | 3.28 (2.14–5.03) | 12.3 (9.47–16.0) | 9.85 (6.85–14.2) |
| Endometriosis | 0.37 (0.27–0.51) | 0.74 (0.51–1.07) | 1.02 (0.84–1.23) | 0.95 (0.77–1.17) | 0.80 (0.67–0.95) | 0.95 (0.78–1.15) |
| Pain | 1.70 (1.12–2.57) | 1.53 (0.95–2.46) | 2.20 (1.66–2.91) | 2.08 (1.53–2.83) | 2.02 (1.55–2.63) | 1.89 (1.42–2.52) |
| Other | 0.66 (0.46–0.96) | 1.81 (1.14–2.89) | 1.11 (0.84–1.46) | 1.37 (1.00–1.87) | 0.92 (0.72–1.18) | 1.34 (1.02–1.78) |
| Concurrent procedure | ||||||
| Ovarian procedure | 0.33 (0.26–0.42) | 0.08 (0.05–0.12) | 0.89 (0.76–1.03) | 0.71 (0.58–0.86) | 0.68 (0.59–0.78) | 0.42 (0.36–0.51) |
| Prolapse | 34.0 (26.0–44.5) | 1.68 (1.07–2.64) | 0.87 (0.57–1.34) | 0.50 (0.29–0.85) | 13.4 (10.4–17.2) | 2.28 (1.59–3.26) |
| Other or none | Reference | Reference | Reference | Reference | Reference | Reference |
| Hospital | ||||||
| Large hospital (≥ 100 beds) | 1.23 (1.04–1.44) | 2.09 (0.19–22.7) | 0.60 (0.51–0.70) | 0.47 (0.08–2.67) | 0.86 (0.76–0.98) | 0.66 (0.19–2.29) |
| Urban area location | 0.41 (0.54–0.31) | 0.25 (0.02–3.18) | 11.1 (30.3–4.07) | 22.2 (2.6–192.3) | 0.77 (0.59–1.01) | 1.84 (0.47–7.32) |
Note: Adjusted OR = adjusted odds ratio, CI = confidence interval, OR = odds ratio. Odds ratios for these routes of hysterectomy are calculated relative to the abdominal route. Adjusted for period (yr), age, rural residence, socioeconomic status, indication for surgery, concurrent procedures and hospital characteristics. *Minimally invasive hysterectomies include vaginal and laparoscopic hysterectomies. †Derived from residential postal codes.