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Complication Prediction Tool

Based on 3000 hysterecomy cases, we created a complication prediction tool designed to be used by general gynaecologists or those with fellowship training in Minimally Invasive Gynaecologic Surgery (MIGS). The model derivation included procedures performed by Generalist and MIGS Fellowship-trained surgeons, so Gynaecologic Oncologists or Urogynaecologists should not use the tool. Details about our model are below. Completing this form will allow you to determine your patient’s individualized risk of a significant complication at hysterectomy with the option of printing a handout.

About the Model

Using over 3000 cases from our network, we created a model to determine factors most predictive of more serious complications at the time of hysterectomy (≥2 complications based on the Clavien Dindo Scale). Hysterectomy cases used to create this model were completed by General Gynaecologists and those with fellowship training in Minimally Invasive Gynaecologic Surgery. Cases completed by Gynaecologic Oncologists or Urogynaecologists were not included.

Our outcome of interest, therefore, was a Grade 2 or greater complication based on the Clavien-Dindo Scale. The predicted probability of a Grade 2 or greater complication is generated using a logistic regression model. The final variable inclusions are based on an AIC based step selection procedure along with the consensus of our clinical team. The strongest predictors of serious complication are as follows: Previous caesarean section (OR 1.46); open surgical approach (OR 1.80); preoperative anemia (OR 1.54); ASA Class 3 (OR 1.70); ASA Class 4 (OR 3.42); presence of intraoperative endometriosis (OR 1.37); presence of intraoperative adhesions (OR 1.26).