Original ArticleInpatient Laparoscopic Hysterectomy in the United States: Trends and Factors Associated With Approach Selection
Section snippets
Materials and Methods
We used the 2007 to 2012 National (Nationwide) Inpatient Sample (NIS) data to identify all nonobstetric laparoscopic hysterectomies performed in the inpatient setting in women aged 18 years and older. The NIS data are part of the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project and include a 20% stratified, random sample of discharges from short-term, nonfederal US hospitals. The NIS is the largest publicly available, all-payer national database of inpatient
Laparoscopic Hysterectomy in 2012
In 2012, a total of 101,005 inpatient laparoscopic hysterectomies were performed in the United States, with 84,080 (83.2%) cases done for benign indications (Table 1, weighted results). The TLH approach accounted for 48.3% of all laparoscopic hysterectomies, followed by LAVH at 37.3% and LSH at 14.4%. Most benign laparoscopic cases were performed either by TLH (42.5%) or LAVH (40.3%), whereas the majority of malignant cases were performed by TLH (76.9%). Nearly one-half of the laparoscopic
Discussion
Using nationally representative data on patients undergoing inpatient laparoscopic hysterectomy for benign indications, we have demonstrated increased use of TLH between 2007 and 2012. By 2012, TLH accounted for the largest proportion of inpatient laparoscopic hysterectomies for benign cases, whereas the use of LAVH declined steadily and utilization of LSH, the least-used approach, decreased slightly. Along with clinical factors, patient sociodemographic and hospital characteristics also were
Acknowledgments
This study was supported in part by funds from the McDevitt Award for Excellence in Research awarded by the Blue Cross Blue Shield of Michigan Foundation.
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The authors declare that they have no conflict of interest.