Complications following hysterectomy in women with intellectual and developmental disabilities |
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| Institution: | 1. UConn Health, Department of Obstetrics and Gynecology, 263 Farmington Avenue Farmington, CT 06030, USA;2. University of Massachusetts Chan Medical School, 55 Lake Ave N, Worcester, MA, 01655, USA;3. The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management Brandeis University, 415 South Street Waltham, MA, USA;4. UMass Memorial Health Department of Obstetrics and Gynecology Memorial Campus, 119 Belmont Street, Jaquith Building Floor 2, Worcester, MA, 01605, USA;1. School of Health Technology and Management, Stony Brook University, Stony Brook, United States;2. College of Arts and Sciences, Whitworth University, United States;3. Renaissance School of Medicine, Stony Brook University, Stony Brook, United States;1. Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;2. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia;3. Office of the Director, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;1. VA Puget Sound Health Care System, Seattle, WA, USA;2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA;3. Department of Psychiatry and Behavioural Sciences, University of Washington, Seattle, WA, USA;1. Department of Behavioral Health and Nutrition, University of Delaware, United States;2. Kinesiology and Applied Physiology, University of Delaware, United States;1. Oklahoma State University Center for Health Sciences, College of Osteopathic Medicine, Office of Medical Student Research, Tulsa, OK, USA;2. Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA;3. Department of Surgery, Oklahoma State Medical Center, Tulsa, OK, USA;4. Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA;5. Department of Family Medicine, Alliance Health, Durant, OK, USA;1. School of Medical Sciences, University of Campinas, Campinas, SP, 13083-887, Brazil;2. Department of Kinesiology, University of Wisconsin-Eau Claire, Eau Claire, WI, 54702, USA;3. Department of Physical Therapy, College of Health Professions, Wichita State University, Wichita, KS, 67260-0043, USA;4. Department of Kinesiology, Mississippi State University, Starkville, MS, 39762, USA |
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| Abstract: | BackgroundLimited data exist on complications following hysterectomy among women with intellectual and developmental disabilities (IDD).ObjectiveThe objective was to assess the frequencies of postoperative complications in women with IDD following hysterectomy.MethodsThe National Inpatient Sample from 2014 to 2017 was queried using codes from the International Classification of Disease 9th and 10th revisions to identify women over 15 years of age with a diagnosis of an IDD undergoing hysterectomy. Comparisons were made to women without IDD undergoing the same procedure. Logistic regression analysis was performed to examine between group differences in the frequency of clinical post-surgical complications while adjusting for potential confounding variables.ResultsOf eligible women undergoing hysterectomy, 1,370 were identified as having IDD and 624,700 did not. Compared to controls, women with IDD were significantly younger (45 vs. 50 years, p < 0.001). Women with IDD were also more likely to have had governmental health insurance (83% vs. 34%, p < 0.001), an open hysterectomy approach (78% vs. 69%, p = 0.002), and longer hospital stays (4 vs. 3 days, p < 0.001). After adjusting for potential confounders, women with IDD had greater odds of postoperative urinary complications (OR 3.74, 95% CI 1.18–11.83) and complications related to decubitus ulcer formation (OR 8.97, 95% CI 2.10–38.36).ConclusionsWomen with IDD have increased odds having urinary and decubitus ulcer complications following hysterectomy, compared to women without IDD. These results inform surgical decision-making and anticipatory guidance for these women and their caregivers. |
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| Keywords: | Surgery Gynecology Disability Disparities Health outcomes |
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