Denominator (n=5920) | Received hysterectomy, % (n) | Unadjusted risk ratio | Adjusted risk ratio | 95% CI | P value |
Total | 27.1 (1606) | ||||
Age group (years) | 0.0713 | ||||
18–34 | 17.4 (62) | 0.58 | 0.79 | 0.61 to 1.03 | |
35–39 | 25.5 (181) | 0.83 | 0.84 | 0.71 to 0.99 | |
40–44 | 25.7 (478) | 0.88 | 0.91 | 0.82 to 1.01 | |
45–49 | 29.9 (652) | 1 | 1 | – | |
50–60 | 29.1 (233) | 0.97 | 0.88 | 0.77 to 1.01 | |
Ethnicity | 0.1184 | ||||
White | 26.8 (1350) | 1 | 1 | – | |
Asian or Asian British | 27.7 (44) | 1.04 | 0.75 | 0.91 to 1.00 | |
Black or black British | 34.9 (88) | 1.30 | 1.13 | 1.09 to 1.39 | |
Other | 32.6 (30) | 1.20 | 0.88 | 0.62 to 1.26 | |
Socioeconomic deprivation (IMD†) | 0.3004 | ||||
Quintile 1 (most deprived) | 28.2 (378) | 1 | 1 | – | |
Quintile 2 | 24.4 (298) | 0.86 | 0.93 | 0.80 to 1.08 | |
Quintile 3 | 26.3 (319) | 0.93 | 0.97 | 0.84 to 1.11 | |
Quintile 4 | 29.4 (344) | 1.04 | 1.01 | 0.94 to 1.24 | |
Quintile 5 (least deprived) | 27.4 (267) | 0.97 | 1.03 | 0.89 to 1.19 | |
BMI categories | 0.0450* | ||||
≤25 | 24.7 (399) | 1 | 1 | – | |
25–30 | 29.7 (465) | 1.20 | 1.15 | 1.03 to 1.29 | |
≥30 | 28.0 (400) | 1.13 | 1.08 | 0.96 to 1.21 | |
Parity | 0.2340 | ||||
Nulliparous | 25.4 (165) | 1 | 1 | – | |
Parous | 27.4 (1404) | 1.09 | 0.95 | 0.82 to 1.10 | |
Number of comorbidities | 0.3223 | ||||
0 | 27.0 (1039) | 1 | 1 | – | |
1 | 26.5 (414) | 0.98 | 0.97 | 0.86 to 1.08 | |
≥2 | 29.9 (153) | 1.11 | 1.12 | 0.95 to 1.32 | |
Severity score at baseline (quintiles) | <0.0001*** | ||||
Quintile 1 (least severe) | 22.0 (251) | 1 | 1 | – | |
Quintile 2 | 26.0 (362) | 1.18 | 1.17 | 1.00 to 1.37 | |
Quintile 3 | 28.2 (271) | 1.28 | 1.26 | 1.07 to 1.49 | |
Quintile 4 | 26.3 (326) | 1.20 | 1.23 | 1.05 to 1.43 | |
Quintile 5 (most severe) | 33.9 (365) | 1.54 | 1.57 | 1.34 to 1.83 | |
Duration of symptoms at baseline | 0.0078** | ||||
<1 year | 24.2 (273) | 1 | 1 | – | |
≥1 year | 28.0 (1304) | 1.16 | 1.20 | 1.05 to 1.36 | |
Prior treatment for HMB in primary care | 0.0005*** | ||||
No | 30.8 (389) | 1 | 1 | – | |
Yes | 26.2 (1185) | 0.86 | 0.80 | 0.71 to 0.89 | |
HMB-related condition | |||||
No obvious cause | 14.7 (360) | 1 | 1 | – | <0.0001*** |
Uterine fibroids and/or polyps (no endometriosis) | 30.6 (847) | 1.99 | 2.11 | 1.86 to 2.41 | |
Endometriosis (with or without uterine fibroids/polyps) | 59.5 (332) | 3.79 | 3.91 | 3.41 to 4.48 |
Multivariable model adjusted for age group, ethnicity, IMD, baseline BMI, parity and number of comorbidities, baseline symptom severity and HMB treatment received in primary care. A total of 699 women received both endometrial ablation (EA) and a hysterectomy in the year following their first outpatient visit. Here they are included in the EA group as this represents the first surgical treatment choice. Categories compared using the Wald test.
*P<0.05; **P<0.01; ***P<0.001.
†Index of Multiple Deprivation, an area-level measure of relative socioeconomic deprivation.
BMI, body mass index; HMB, heavy menstrual bleeding.