Thirty-day postoperative mortality after hysterectomy in women with liver cirrhosis: a Danish population-based cohort study

Background: Women with liver cirrhosis have a higher incidence of hysterectomy than the general population, generally because of abnormal bleeding. They may also have an increased risk of postoperative mortality and morbidity. Methods: In the nationwide Danish National Patients Register (NPR) we identified all women diagnosed with liver cirrhosis from 1977 to 1993. From this cohort we selected all women undergoing hysterectomy. A random sample of women without liver cirrhosis undergoing hysterectomy was selected as controls. Outcome was defined as mortality within the first 30 days after discharge. Logistic regression analysis was used to estimate the association between liver cirrhosis and 30-day postoperative mortality, adjusted for age, comorbidity, and type of admission. Results: Out of 8539 women with liver cirrhosis 105 under-went hysterectomy. We found a 30-day postoperative mortality of 7.6% (95% confidence interval (CI) 2.5-12.7%) and 0.6% (95% Cl 0.5-0.7%) in women with and without liver cirrhosis, respectively. The crude odds ratio was 14 (95% CI 6.5-29) and the adjusted odds ratio was 11 (95% Cl 4.8-24) for 30-day postoperative mortality in women with liver cirrhosis compared with non-cirrhotic controls. Conclusion: Hysterectomy in women with liver cirrhosis is associated with an 1 I-fold increased risk of death within the first 30 days after discharge. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.