Correlation between Body Mass Index and Length of Hospital Stay in Women Who Undergo Abdominal Hysterectomy

Background: Hysterectomy for benign gynecologic conditions is the second most commonly performed surgery in women of reproductive age. Management of several benign conditions has evolved, reducing the need for early invasive surgery. Yet, some patients will require major surgery to resolve their conditions. Obesity - a body mass index (BMI) of >30 - is an epidemic in the United States. In 2010 >40 million women were considered to be obese, comprising >35.8% of U.S. females. Objective: The aim of this study was to identify risk factors for prolonged hospital stays after total abdominal hysterectomies for benign gynecologic conditions. Materials and Methods: A retrospective chart review was performed for patients who underwent abdominal hysterectomies, between 2003 and 2010, for benign gynecologic conditions, at the Nassau University Medical Center, in East Meadow, NY. The primary outcome variable was postoperative stay >4 days. Independent outcome variables included BMI, age, ethnicity, preexisting medical conditions, operative times >120 minutes, and need for postoperative blood transfusions. Results: A total of 325 charts were analyzed. The average BMI was 30 (18.5-55.4); 8.3% patients had hospital stays >4 days; 82% were nonwhite; 25% had hypertension; <10% had asthma or diabetes; 92% patients had surgery times >120 minutes; and 2.8% had postoperative transfusions. Increased BMI was significantly associated with length of stay (LOS) >4 days (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.04-1.15; p-value = 0.001). Postoperative transfusions were also associated with prolonged LOS (OR: 7.17; 95% CI: 1.4-34.95; p-value = 0.02). Conclusions: BMI was identified as the only modifiable preoperative long-stay risk factor in patients undergoing abdominal hysterectomy. Postoperative need for blood transfusion was the only other variable that affected LOS.