Analysis from the French DRG-based information system (PMSI) of conservative surgical treatment for abnormal uterine bleeding in 2008-2010

作者：Fernandez H^*; Villefranque V; Panel P

来源：Journal de Gynecologie Obstetrique et Biologie de la Reproduction, 2015, 44(5): 411-418.

DOI：10.1016/j.jgyn.2015.01.009

• Uterine bleeding
• First generation
• Second generation
• Information system
• databases
• Ambulatory care

Objective. - To evaluate the conservative surgical treatment for abnormal uterine bleeding from the Medicalized Information System Program (PMSI).
Materials and methods. - The diagnosis codes were selected from 10th version of the international classification disease. A transversal and longitudinal descriptive analysis was performed from hospital stays, patient's characteristics, medical procedures between 2008-2010.
Results. - Nineteen thousand six hundred and seventy-nine patients were admitted in hospital (public or private) for treatment of abnormal uterine bleeding. Endometrial ablation increased by 16,7%, 10.2% for first generation technique (G1) and 63.5% for second generation techniques (G2). G2were used in 15% of indications. The median age was respectively 45.2 +/- 6.4 years old versus 45.8 +/- 4.9 years old for G2. The median length of hospital stay was 1.6 +/- 1 with 69% of patients in ambulatory care. The likelihood to have a hysterectomy in the 3years follow-up was higher after G1 than G2 treatments (P=0.0034) for the patients above 40 years old. In longitudinal study, defined only by endometrial hyperplasia, 11,532 patients were included and only 8.2% had been treated by G2.
Conclusion. - In spite of the international guidelines since 2008, 85% of patients treated with first generation surgical technique. The failure rate defined by a re-ablation or a hysterectomy is higher after G1. This result must be discussed in relationship with cost effective aspects.

• 出版日期2015-5