Practice variation in bilateral salpingo-oophorectomy at benign abdominal hysterectomy: a population-based study

BackgroundBilateral salpingo-oophorectomy at benign hysterectomy is not recommended in premenopausal women who are the stage because of its potential associations with increased all-cause mortality and cardiovascular disease; however, contemporary practice patterns unknown.ObjectiveThis study aimed to quantify between-surgeon variation bilateral identify surgeon patient characteristics associated evaluate current quality care targets for knowledge translation future research.Study DesignWe conducted a population-based retrospective cross-sectional adult (?20 years) undergoing abdominal from 2014 2018 Ontario, Canada. Hierarchical multivariable logistic regression models, stratified by age group (<45, 45–54, ?55 years), were used model after adjustment characteristics. Cases classified as potentially appropriate or avoidable based on presence absence diagnostic indications.ResultsOf 44,549 eligible women, 17,797 (39.9%) underwent concurrent salpingo-oophorectomy, 26,752 (60.1%) did not. In all three strata, individual providing was one strongest factors influencing whether patients received (median odds ratio, 2.00–2.53). Surgeons accounted more than 22% residual observed aged 45–54 years compared 16% 14% <45 years, respectively. Non-gynecologic factors, such obesity (odds 1.33; 95% confidence interval, 1.17–1.52; P<.001) residing low-income regions 1.34; 1.16–1.55; P<.001), also salpingo-oophorectomy. Approximately 40% had no indication procedure their discharge records.ConclusionMarked rates, even adjusting case mix, suggests ongoing uncertainty practice. Stronger evidence-based guidelines risks benefits needed, particularly focusing perimenopausal women. Bilateral unknown. This research. We indications. Of records. Marked