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Association Between Opioid Use Disorder and Hysterectomy Outcomes
Stephanie L Lim1, Natalie Wickenheisser, Tracy Truong
1Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, and the Department of Obstetrics and Gynecology, Duke University Medical Center, and the Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina.
Obstetrics and Gynecology
|August 6, 2026
Summary
Patients with opioid use disorder (OUD) face higher complication risks and costs following hysterectomy. This highlights the need for enhanced preoperative care for OUD patients undergoing this surgery.
Area of Science:
- Gynecology
- Public Health
- Health Services Research
Background:
- Opioid use disorder (OUD) is a growing public health concern.
- Hysterectomy is a common gynecological procedure with significant healthcare implications.
- Understanding the impact of OUD on surgical outcomes is crucial for patient care.
Purpose of the Study:
- To investigate the association between opioid use disorder (OUD) and hysterectomy outcomes.
- To analyze complications, length of stay, and hospital charges in patients with and without OUD undergoing hysterectomy.
Main Methods:
- Retrospective cohort study using Nationwide Ambulatory Surgery Sample and National Inpatient Sample databases (2016-2021).
- Included patients aged 18+ undergoing outpatient or inpatient hysterectomy for benign/malignant indications.
- Utilized ICD-10 and CPT codes to identify OUD; analyzed outcomes using modified Poisson, negative binomial, and gamma regression models.
Main Results:
- Patients with OUD had higher composite complication rates in both outpatient (3.8% vs 3.4%) and inpatient (14.7% vs 11.8%) settings.
- Inpatient hysterectomy for OUD patients was associated with longer length of stay (4.3 vs 3.2 days) and increased hospital charges ($91,258 vs $71,809).
Conclusions:
- Patients with OUD experience increased complications after hysterectomy.
- OUD is linked to longer hospital stays and higher costs for inpatient hysterectomy.
- Preoperative optimization and education may improve outcomes for OUD patients.
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