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The Danish Hysterectomy and Hysteroscopy Database
Märta Fink Topsoee1, Else Helene Ibfelt2, Annette Settnes1
1Department of Obstetrics and Gynecology, North Zealand Hospital, University of Copenhagen.
Insights
The Danish Hysterectomy and Hysteroscopy Database (DHHD) tracks benign uterine surgeries to improve patient outcomes. This initiative has led to reduced complications and hospital stays, enhancing surgical quality.
Area of Science:
- Gynecological Surgery
- Health Informatics
- Public Health
Background:
- The Danish Hysterectomy and Hysteroscopy Database (DHHD) was established to improve the quality of care for women undergoing benign uterine surgery.
- Key objectives include reducing complications, hospital readmissions, and reoperations, while also defining hospitalization needs and establishing national standards.
Approach:
- The DHHD includes all women in Denmark undergoing elective benign uterine surgery (hysterectomy and operative hysteroscopy) since 2003.
- Data are extracted from the National Patient Register (NPR), encompassing surgical techniques, lifestyle factors, and mandatory complication/readmission reporting.
Key Points:
- Approximately 4,300 hysterectomies and 3,200 operative hysteroscopies are performed annually in Denmark.
- Over 50,000 hysterectomies have been registered since the database's inception in 2003.
- DHHD's work has resulted in national guidelines, improved surgical practices, and organized national meetings and workshops.
Conclusions:
- The past decade has seen increased utilization of vaginal and laparoscopic hysterectomy.
- A decline in overall complication rates and hospital stay duration has been observed.
- Regional variations in surgical methods have also diminished, indicating greater standardization of care.
Aim Of The Database:
The steering committee of the Danish Hysterectomy and Hysteroscopy Database (DHHD) has defined the objective of the database: the aim is firstly to reduce complications, readmissions, reoperations; secondly to specify the need for hospitalization after hysterectomy; thirdly to secure quality assessment of hysterectomy and hysteroscopy by setting standards and national guidelines; and finally to intensify the monitoring of laparoscopic surgery and explore long-term side effects after hysterectomy.
Study Population:
We include all women in Denmark who have had elective benign uterine surgery since 2003. The surgery includes hysterectomy and operative hysteroscopy. In the latter, we include resection of the endometrium and submucosal leiomyomas and ablations of the endometrium.
Main Variables:
Detailed information about the hysterectomy and hysteroscopy operation techniques, cooperations, and indications is registered directly in the National Patient Register (NPR), as well as relevant lifestyle factors and confounders. It is mandatory to register information about complications and readmissions in the NPR. Data included in DHHD are directly extracted from the NPR.
Descriptive Data:
Annually approximately 4,300 hysterectomies and 3,200 operative hysteroscopies are performed in Denmark. Since the establishment of the database in 2003, 50,000 hysterectomies have been registered. DHHD's nationwide cooperation and research have led to national guidelines and regimes. Annual national meetings and nationwide workshops have been organized.
Conclusion:
The use of vaginal and laparoscopic hysterectomy methods has increased during the past decade and the overall complication rate and hospital stay have declined. The regional variation in operation methods has also decreased.
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