Trends in Hysterectomy Rates Associated With the Coronavirus Disease 2019 (COVID-19) Pandemic

Abstract

OBJECTIVE: To compare nationwide trends in the rate of inpatient and outpatient hysterectomy between 2019 and 2020 during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Using weighted data from the National Inpatient Sample and the National Ambulatory Surgery Sample, we examined the number of hysterectomies performed by month from 2019 through 2020. Monthly trends were compared between years overall, stratified by the route of surgery (abdominal, laparoscopic, and vaginal) and by indication for surgery (benign, preinvasive, cancer). Trends analyses were conducted using Joinpoint regression and reported as average monthly percentage change (AMPC). Differences in demographic characteristics between the years were compared using χ2 tests. RESULTS: From January 2019 through December 2020, after weighting, 1,029,792 hysterectomies were performed, including 548,802 (53.2%) in 2019 and 480,990 (46.7%) in 2020. Starting in January 2020, monthly cases declined significantly, from 40,240 to a nadir of 10,566 hysterectomies in April 2020 (AMPC −29.2%, 95% CI −39.8% to −16.8%) (P<.001). The subsequent months saw a significant increase in cases, from the nadir in April 2020 to 40,023 cases in July 2020 (AMPC 39.4%, 95% CI 18.6–63.9%) (P=.001), which then stabilized to the end of the year (AMPC −1.3%, 95% CI −4.8% to 2.4%) (P=.46). In March 2020 there was a 24.0% decrease, in April 2020 a 74.2% decrease, and in May 2020 a 35.1% decrease compared with the respective months in 2019. The rates of vaginal hysterectomy declined more than the rates of other routes of surgery, and procedures performed for benign and preinvasive disease decreased more than those for cancer. CONCLUSION: The rate of hysterectomy in the United States decreased in 2020 compared with 2019, with the greatest decrease from March to May of 2020, corresponding with the initial wave of COVID-19.

National Estimates of Gender-Affirming Surgery in the US

“…Not unexpectedly, a large number of the procedures we captured were performed in the ambulatory setting, highlighting the need to capture both inpatient and outpatient procedures when analyzing data on trends. Like many prior studies, we noted a decrease in the number of procedures performed in 2020, likely reflective of the COVID-19 pandemic . However, the decline in the number of procedures performed between 2019 and 2020 was relatively modest, particularly as these procedures are largely elective.…”

“…Like many prior studies, we noted a decrease in the number of procedures performed in 2020, likely reflective of the COVID-19 pandemic. 18 However, the decline in the number of procedures performed between 2019 and 2020 was relatively modest, particularly as these procedures are largely elective.…”

Pregnant patients undergoing cholecystectomy: nationwide assessment of clinical characteristics and outcomes

“…The analytical approach in the current study followed the previous studies using both the National Inpatient Sample and the Nationwide Ambulatory Surgery Sample to assess the national estimates. 17 , 18 Frequency tables for the exposure–outcome analysis were generated in the weighted model for national estimates in each database separately. Summation was then performed to aggregate the outputs for the 2 data sets.…”