INTRODUCTION:Hysterectomy is one of the most common gynecologic surgeries performed on women, including women with ESRD awaiting kidney transplantation. Despite this, studies of hysterectomy among ESRD patients are limited to small, single center reviews. We studied outcomes of ESRD patients following hysterectomy in a nationally representative database.

METHODS: The Nationwide Inpatient Sample was used to study 2,330 ESRD and 4.4 million non-ESRD patients who underwent hysterectomy (2000-2011). Mortality, complication rates, length of stay (LOS), and hospital costs were compared using hierarchical logistic regression and log-linear models respectively.

RESULTS: ESRD patients had higher mortality (1.4% vs 0.1% p<0.001, adjusted OR 3.18, 95% CI 1.46 – 6.95) and postoperative complication rates (24.3% vs 11.1% p<0.001, adjusted OR 1.35, 95% CI 1.07 – 1.72) than non-ESRD patients. They were at a greater risk of infectious (OR 2.17, 95% CI 1.28 – 3.69), mechanical wound (OR 1.89, 95% CI 1.06 – 3.39), shock (OR 2.89, 95% CI 1.64 – 5.09), and intraoperative complications (OR 1.50, 95% CI 1.00 – 1.27). LOS was longer (5 vs 3 days p<0.001, Ratio 1.28; 95% CI 1.23 – 1.34) and costs were higher ($12012 vs $5830 p<0.001, Ratio 1.37; 95% CI 1.31 – 1.43).

CONCLUSIONS: ESRD patients experience higher postoperative mortality, complication rates, longer LOS, and higher costs following hysterectomy when compared to non-ESRD counterparts. Interventions targeting better control of postoperative wound and infectious complications may allow for improvement in outcomes of KT candidates following hysterectomy.

CITATION INFORMATION: Olorundare I, DiBrito S, Haugen C, Garonzik-Wang J, Segev D. Outcomes After Hysterectomy in Patients with End Stage Renal Disease. Am J Transplant. 2017;17 (suppl 3).

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