ABSTRACT
This study enrolled nearly 1300 women having hysterectomy for benign indications at 28 hospitals during 1992 and 1993. Of these procedures, 816 were performed abdominally, 311 vaginally, and 154 were laparoscopic-assisted vaginal hysterectomies (LAVH). On average, LAVH was more expensive ($4294) than abdominal ($2753) and vaginal ($2312) hysterectomies, primarily due to higher operating room and surgical supply costs. Women who had LAVH were younger, had higher incomes, were more educated, more likely to be treated at nonteaching and smaller hospitals, and had lower comorbidity scores than those in the other two groups. After adjusting for these differences, LAVH was not significantly different from vaginal hysterectomy in terms of operative and postoperative complications, readmissions, postoperative days of pain, days in bed, days of feeling tired, days before resuming full activities, and days before going back to work full time. Compared with abdominal hysterectomy the vaginal groups combined had significantly fewer days of pain, days of feeling tired, and days back to work full time. By 6 months after surgery the three groups were quite similar in terms of patient satisfaction and other outcome measures.
ABSTRACT
The correlation between myocardial infarct size estimated by the complete version of the Selvester QRS scoring system and that documented by pathoanatomic studies has been reported for single anterior, inferior and posterolateral infarcts. Although previous studies described electrocardiographic changes in patients with multiple infarcts, no quantitative documentation of the ability of such changes to estimate the total amount of left ventricular infarction has been reported. This study of 32 patients with anatomically documented multiple infarcts shows a significant correlation between QRS-estimated and anatomically documented sizes (r = 0.44; p = 0.01), which is less than that previously reported for single infarcts in the anterior, inferior and posterolateral locations. Several of the 54 electrocardiographic criteria were never satisfied. Criteria for posterior infarction were seldom present, suggesting "cancellation effect" of coexisting anterior infarction. These results will be the basis for future modification of QRS criteria for estimating myocardial infarct size.
