Impact of inflammatory bowel disease on perioperative complications in patients undergoing hysterectomy

The global prevalence of inflammatory bowel disease (IBD) is escalating rapidly, with its associated systemic inflammation and immune dysregulation potentially compromising surgical outcomes. Nevertheless, IBD's influence on perioperative complications following hysterectomy remains unreported. This investigation sought to examine the relationship between IBD and perioperative complications in hysterectomy patients utilizing the National Inpatient Sample database while analyzing associated risk factors.

Data for patients who underwent hysterectomy between 2016 and 2022 were obtained from the National Inpatient Sample (NIS) database using International Classification of Diseases, Tenth Revision, Clinical Modification codes. Patients younger than 18 years were excluded. Patients were stratified according to the presence or absence of IBD, and demographic characteristics, hospital characteristics, comorbidities, and perioperative outcomes were compared between groups. Statistical analyses included Pearson's χ² test, Wilcoxon rank-sum test, and multivariable logistic regression.

Among 187,401 hysterectomy patients, 853 (0.46%) had comorbid IBD. The prevalence of IBD increased from 0.40% in 2016 to 0.51% in 2022. After multivariable adjustment, IBD was associated with higher odds of sepsis (OR = 3.060; 95% CI = 2.095-4.470), shock (OR = 3.031; 95% CI = 1.605-3.722), acute kidney injury (AKI) (OR = 1.643; 95% CI = 1.235-2.184), urinary tract infection (UTI) (OR = 1.882; 95% CI = 1.332-2.659), and in-hospital mortality (OR = 3.827; 95% CI = 1.855-7.893).

IBD prevalence among hysterectomy patients increased over time. IBD was associated with higher odds of selected perioperative outcomes, including sepsis, shock, AKI, UTI, and in-hospital mortality. These associations should be interpreted cautiously given the retrospective administrative database design.