UPMC-Led Improvements in Hysterectomy Outcomes Presented at National Meeting

By: Allison C. Marin

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UPMC gynecological research takes the national stage today as Robert Edwards, M.D., Milton Lawrence McCall Professor & Chair, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, presents recent findings on the benefits of UPMC’s hysterectomy decision-making guidelines at the American Congress of Obstetricians and Gynecologists 64th Annual Clinical and Scientific Meeting in Washington, D.C.

The decision-making guidelines, which help surgeons pick the most appropriate surgical method for each patient, reduced more invasive surgeries by more than 35 percent and significantly improved patient outcomes.

In response to statistics showing that open abdominal hysterectomies are associated with more difficult recovery and worse patient outcomes than minimally invasive laparoscopic, robotic-assisted or vaginal approaches, UPMC developed the guidelines in 2012. The goal was to reduce variations in surgical care and minimize unnecessary open abdominal procedures, Dr. Edwards explained.

In this morning’s oral presentation, Dr. Edwards will describe the results from an analysis of surgical methods and patient outcomes in the two-year period after the guidelines were first put into use.

“We found that the number of open abdominal procedures dropped significantly after instituting the decision-making guidelines,” Dr. Edwards said. In 2012, open procedures made up 29 percent of all hysterectomies. By 2014, they had dropped to only 18 percent. “That’s quite a significant improvement for a health care system of our size,” he added.

Even more importantly, the researchers saw improvements in several patient outcomes over the same time period. As the number of open abdominal hysterectomies decreased, patients had less blood loss, shorter hospital stays, fewer wound infections and quicker returns to work.

“Clearly, use of our decision tool leads to better patient care,” Dr. Edwards said.

Some of the results he will present were published in the January 2016 issue of the journal Obstetrics & Gynecology.

Additional researchers on the project include Faina Linkov, Ph.D., M.P.H., John Comerci, M.D., and Suketu Mansuria, M.D., all of the Pitt School of Medicine.