Endometriosis Hospitalization Trends in Spain

The hospital admission trends of endometriosis patients in Spain differed over the years, study shows

Key Points

Highlight

• Elective surgery admissions decreased from 2003 to 2019 in Spain but emergency hospitalizations due to endometriosis have been growing since 2012.

Importance

• Identifying the trends of hospital admissions may shed light on the development of the management and the economic burden of the disease.

What’s done here

• This is an observational study performed to determine the hospital admission trends of endometriosis patients over a period of 10 years in Spain.
• The variables of age, admission year, admission type, presence of surgical intervention, and length of hospital stay were evaluated in patients that were hospitalized for intra-uterine endometriosis and the results were statistically analyzed.

Key results

• The rate of annual elective surgery admissions decreased significantly from 22.1 to 17.6 per 100,000 people.
• The elective surgery admissions increased significantly until 2003 after which it started dropping.
• The emergency admissions showed a significant average increase of 2% per year until 2019 starting from 2012.
• A gradual decline was witnessed for both types regarding the length of hospital stay until 2012 after which a fluctuation pattern was detected.

Limitations

• Not having access to patients’ individual variables such as medical history and comorbidities
• Not having information on readmissions of the same patient in the same year

Lay Summary

According to the general assumption, one in every ten women is believed to have endometriosis. However, recent literature shows a big difference in the prevalence rates ranging from 1 to 5%, likely because most cases remain undiagnosed. The need for hospital admissions in endometriosis patients on the other hand has decreased in the latest years owing to the fact that outpatient care for these patients has increased.

A group of researchers from Alicante, Spain, led by Dr. A. Queseda conducted an observational study to determine the trend in hospital admission rates related to endometriosis over a 10-year period aiming to assess the cost of the disease and the development of the disease management. The study was published in the September 2022 issue of the journal "Postgraduate Medicine".

The data on women aged between 15 to 54 years and hospitalized for intra-uterine endometriosis was reached from the hospital database and evaluated for variables such as age, admission year, admission type, presence of surgical intervention, and length of hospital stay. A total of 100,148 admissions were identified with 80.8% being for elective surgeries and 19.2% being general emergency admissions.

The rate of annual elective surgery admissions was seen to decrease significantly from 22.1 to 17.6 per 100,000 people as well as the emergency hospitalization rate from 9.1 to 6.1. The elective surgery admissions rose significantly until 2003 after which it dropped continuously whereas the trend in emergency admissions was the opposite as it showed a dramatic decline until 2012 and then surged significantly with an average increase of 2%. The decline in elective admissions that started in 2003 was thought to be the result of a change in hospital management that called for fewer hospital beds to save more and a shift in the management of testing which was done in an inpatient setting up until 2003. The authors also stated that the decrease in elective surgery admissions could be explained by the developments in reproductive health management resulting in fewer surgeries to preserve reproductive functions. It was also seen that in terms of the length of hospital stay, emergency admissions were longer than elective surgery admissions. A gradual drop was seen for both types regarding the length of hospital stay until 2012 after which a fluctuation pattern was observed.

It was concluded that a more conservative approach regarding the avoidance is surgery has been taking place allowing for new treatments. Future research may aid in understanding more about the management of this challenging disease.

Research Source: https://pubmed.ncbi.nlm.nih.gov/36124556/