Complication rates of women in Ontario who underwent Endometrial Ablation (EA) over a 15 year interval: A Large cohort analysis involving 76 446 patients
CANSAGE ePoster Library. Vilos A. 09/26/19; 279823; eP-141
Angelos Vilos
Angelos Vilos
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Objectives: To determine the surgical complication risk in women who underwent endometrial ablation (EA) in Ontario over 15 years.
Design: Retrospective cohort study of linked administrative data using ICES. (Canadian Task Force level II-2)Patients: 76 446 women in Ontario who had EA between Oct 1, 2002-Sept 30,2017.Methods: The CIHI, CIHI-DAD, CIHI-SDS, OHIP, NACRS, and the CCI databases were used to identify EA cases, while CCI,OHIP and ICD-10 codes were used to identify primary and secondary outcomes. Exclusion criteria involved missing data, age 105, non-Ontario resident, No matching OHIP record, history of endometrial/ovarian cancer, ineligible concurrent procedure, or previous EA. Primary outcomes included; complications involving GU/GI anatomy, pain, bleeding, transfusion, infection, fistula, fluid overload, thermal injury, VTE. Secondary outcomes included; 30 day mortality, 180 day mortality, length of stay in hospital, ER visit within 30 days, Readmission within 30 days.
Results: 95 754 patients identified, 19 308 excluded; overall complication rate 3656/76 446 (4.8%). The frequency of complications occurred at: Pain (1.4%), infection (1.4%), transfusion (0.3%), fluid overload (0.1%), genitourinary injury (0.1%), VTE (0.02%), and thermal Injury (0.01%). There were no differences in age, geography, income, diabetes, HTN, or obesity in those who did or did not have complications. ASA > 3, previous abdominal/pelvic surgery, or non-bleeding diagnosis prior to EA were associated with greater complications. 6.2% of patients presented to ER and 0.7% were admitted within the first 30 days.
Conclusions: Overall complication rates are higher than previously published but EA remains a safe alternative to hysterectomy.
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