Risk factors for febrile morbidity after hysterectomy.

Abstract:

OBJECTIVE:To identify risk factors for febrile morbidity after hysterectomy for nonmalignant indications. METHODS:We performed a retrospective cohort study of 686 women who had a hysterectomy between January and September 1997 by abdominal (n = 408), laparoscopic-assisted vaginal (n = 90), or vaginal (n = 188) approaches. Potential risk factors for febrile morbidity were extracted from the medical records. By means of multivariable logistic regression, we evaluated demographic, reproductive, clinical, and operative risk factors for febrile morbidity. RESULTS:The risk of postoperative febrile morbidity in this population was 14%. Only 50% of women received prophylactic antibiotics, whereas almost 20% received no antibiotics at all, and 30% were administered antibiotics after surgical incision. Risk factors for febrile morbidity after hysterectomy, after controlling for age, body mass index, operative time, and prophylactic antibiotic administration, were abdominal approach (odds ratio 2.7; 95% confidence interval 1.6, 4.3) and blood loss at surgery of more than 750 mL (odds ratio 3.5; 95% confidence interval 1.8, 6.8). CONCLUSION:Hysterectomy by abdominal approach and increased blood loss at the time of surgery significantly increase the risk of febrile morbidity. Preventive efforts should focus on methods to reduce postoperative febrile morbidity, including meticulous surgical technique and routine use and appropriate timing of prophylactic antibiotic therapy.

journal_name

Obstet Gynecol

authors

Peipert JF,Weitzen S,Cruickshank C,Story E,Ethridge D,Lapane K

doi

10.1097/01.AOG.0000109219.24211.30

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

86-91

issue

1

eissn

0029-7844

issn

1873-233X

pii

103/1/86

journal_volume

103

pub_type

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