Clinical and epidemiological profile of women who underwent hysterectomy in a private network hospital in Teresina – PI

Abstract

Objective: To evaluate the agreement between preoperative diagnoses and histopathological findings in women undergoing hysterectomy at a tertiary hospital in Teresina-PI, from 2022 to 2023. Methods: Cross-sectional study including 376 medical records of patients who underwent hysterectomy, analyzing sociodemographic variables, surgical indications, histopathological findings, and type of surgical approach. Diagnostic accuracy was assessed through sensitivity, specificity, predictive values, overall accuracy, Kappa coefficient, and Chi-square test, considering histopathology as the gold standard. Results: Fibroids were the main surgical indication (47.3%), followed by genital prolapse (21.1%), endometriosis (8.8%), and malignant neoplasms (5.9%). Preoperative diagnosis showed moderate performance for fibroids (sensitivity 67.2%; specificity 90.7%; accuracy 75.3%; κ=0.514; p<0.001), limited performance for endometriosis (sensitivity 60%; specificity 91.9%; accuracy 91.5%; κ=0.14; p<0.001), and low sensitivity for malignant neoplasms (5.6%), despite high specificity (99.2%) and accuracy (94.7%) (κ=0.07; p=0.054). Conclusion: Preoperative diagnosis showed good agreement for fibroids but important limitations for endometriosis and malignant neoplasms. These findings highlight the need for more accurate diagnostic protocols and the adoption of minimally invasive technologies, enabling a more personalized approach, aligned with technological advances, and capable of promoting better clinical outcomes and improved quality of life for patients.