Age‐stratified risk factors of re‐intervention for uterine fibroids treated with high‐intensity focused ultrasound
AbstractObjectiveTo estimate the rate and risk factors of re‐intervention for patients with uterine fibroids (UFs) undergoing high‐intensity focused ultrasound (HIFU) at different age distributions.MethodA retrospective cohort study was conducted in Nanchong Central Hospital, recruiting a total of 672 patients with UFs undergoing HIFU from June 2017 to December 2019. Using univariate and multivariate logistic regression, risk factors for re‐intervention were assessed.ResultsAmong 401 patients with UFs who completed the follow‐up visits (median 47 months, range 34–61), 50 (12.46%) patients underwent re‐intervention (such as high‐intensity focused ultrasound, uterine artery embolization, myomectomy and hysterectomy). In the different age distributions, the re‐intervention rate was 17.5% (34/194) in patients aged <45 years and 7.7% (16/207) in those aged ≥45 years. Regarding the younger patient group (aged <45 years), hypo‐ or iso‐intensive fibroids in T2‐weighted magnetic resonance imaging (T2WI) intensity may elevate the risk of re‐intervention for UFs (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.37–6.62; P = 0.007). Among the older patient group (aged ≥45 years), preoperative anemic patients had an increased risk of re‐intervention compared with those without anemia (OR 3.30, 95% CI 1.01–10.37; P = 0.041).ConclusionThe re‐intervention rate of HIFU decreased with increasing age. Among those aged <45 years, T2WI intensity was the independent risk factor for re‐intervention, and among those aged ≥45 years, preoperative anemic status may be related to re‐intervention outcome.
