Time to Hysterectomy After Transcervical Resection of the Endometrium Based on Age: A Retrospective Cohort Review.

Autor:	Cocks RM; Rural Clinical School (Dr. Cocks), Melbourne Medical School, University of Melbourne, Ballarat, Victoria, Australia; Northern Health (Dr. Cocks), Epping, Victoria, Australia. Electronic address: renee.cocks@gmail.com., Ward MC; Obstetrics and Gynecology Ballarat (Dr. Ward and Dr. R. Dalton), Wendouree, Victoria, Australia; Monash University (Dr. Ward), Clayton, Victoria, Australia., Dalton OP; Ballarat Health Services (Dr. O. Dalton), Ballarat, Victoria, Australia., Dalton RV; Obstetrics and Gynecology Ballarat (Dr. Ward and Dr. R. Dalton), Wendouree, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2023 Sep; Vol. 30 (9), pp. 757-761. Date of Electronic Publication: 2023 May 21.
DOI:	10.1016/j.jmig.2023.05.008
Abstrakt:	Study Objective: To determine the rate of hysterectomy over time after transcervical resection of the endometrium (TCRE) based on age. Design: Retrospective audit. Setting: A single gynecology clinic in regional Victoria, Australia. Patients: A total of 1078 patients who had undergone TCRE for abnormal uterine bleeding. Interventions: The likelihood of hysterectomy was compared across age groups using the chi-square test. Time to hysterectomy was summarized as a median with the 25th and 75th percentiles and compared across age groups using the Kaplan-Meier plot (log-rank test) and Cox proportional hazards regression. Measurements and Main Results: The overall rate of hysterectomy was 24.2% (261 of 1078, 95% confidence interval [CI] 21.7-26.9). When age was categorized into <40 years, 40 to 44 years, 45 to 49 years, and >50 years, the rate of hysterectomy after TCRE was 32.3% (70 of 217), 29.5% (93 of 315), 19.6% (73 of 372), and 14.4% (25 of 174), respectively (p <.001). The likelihood of hysterectomy at any time point after TCRE among those aged 45 to 49 years and older than 50 years was 43% and 59% lower, respectively, than patients under 40 years (hazard ratio, 0.57; 95% CI, 0.41-0.80, and hazard ratio, 0.41; 95% CI, 0.26-0.65, respectively). The median time to hysterectomy was 1.68 years (25th to 75th percentiles, 0.77-3.76). Conclusion: This study demonstrated that patients who underwent a TCRE before the age of 45 years had a higher chance of having a hysterectomy than patients older than 45 years. This information will enable clinicians to inform patients of their chance of undergoing a hysterectomy at any time after TCRE. (Copyright © 2023 AAGL. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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