{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:30:20Z","timestamp":1790998220848,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","award":["2021009"],"award-info":[{"award-number":["2021009"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Hysterectomy and bilateral oophorectomy are common major surgical procedures that have been associated with increased mortality risk. We aimed to assess the association of hysterectomy and\/or bilateral oophorectomy with all\u2010cause and cardiovascular mortality in a Norwegian population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Cohort study with data from The Tr\u00f8ndelag Health Study (HUNT2) linked to the Norwegian Cause of Death Registry, with follow\u2010up from 1996 until 2014 or death. The unexposed group (<jats:italic>n<\/jats:italic>\u00a0=\u200918\u2009673) included women with both their ovaries and uterus intact, while the two exposed groups included women with hysterectomy alone (<jats:italic>n<\/jats:italic>\u00a0=\u20091199), or bilateral oophorectomy with or without hysterectomy (<jats:italic>n<\/jats:italic>\u00a0=\u2009907). We compared mortality in exposed vs unexposed groups and adjusted for relevant covariates by Cox regression. Further, we performed analyses stratified by age at surgery (\u226439, 40\u201352, \u226553\u2009years) and subgroup analyses among women \u226452\u2009years of age at inclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 47\u2009312 women in HUNT2 (1995\u20131997), 20\u2009779 provided complete information regarding gynecological surgery and previous health. The hysterectomy group had increased all\u2010cause mortality (hazard ratio [HR] 1.30, 95% confidence interval [CI] 1.06\u20131.58) and cardiovascular mortality (HR 1.47, 95% CI 1.09\u20131.97). We found no significant association between bilateral oophorectomy and all\u2010cause or cardiovascular mortality in the total population. However, among women \u226452\u2009years at inclusion, cardiovascular mortality was increased in the hysterectomy group (HR 2.71, 95% CI 1.19\u20136.17) with a similar, but less precise estimate in the bilateral oophorectomy group (HR 2.42, 95% CI 0.84\u20136.93).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hysterectomy was associated with increased all\u2010cause and cardiovascular mortality, whereas bilateral salpingo\u2010oophorectomy was not. Among women \u226452\u2009years at inclusion, both hysterectomy and bilateral oophorectomy were associated with a twofold increased risk of cardiovascular mortality, but the results were imprecise. Women after hysterectomy and\/or bilateral salpingo\u2010oophorectomy constitute a group with increased cardiovascular mortality that may need closer attention to cardiovascular disease risk from the healthcare system to ensure timely and effective preventive interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14531","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T06:58:27Z","timestamp":1677135507000},"page":"465-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["All\u2010cause and cardiovascular mortality after hysterectomy and oophorectomy in a large cohort (<scp>HUNT2<\/scp>)"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9534-6255","authenticated-orcid":false,"given":"Trond M.","family":"Michelsen","sequence":"first","affiliation":[{"name":"Division of Obstetrics and Gynecology, Department of Obstetrics Oslo University Hospital  Oslo Norway"},{"name":"Norwegian Research Center for Women's Health Oslo University Hospital  Oslo Norway"},{"name":"Research Unit S\u00f8rlandet Hospital HF  Kristiansand Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9718-5635","authenticated-orcid":false,"given":"Tina Ellinor","family":"Rosland","sequence":"additional","affiliation":[{"name":"Research Unit S\u00f8rlandet Hospital HF  Kristiansand Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology S\u00f8rlandet Hospital Arendal  Arendal Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rn O.","family":"\u00c5svold","sequence":"additional","affiliation":[{"name":"K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Department of Endocrinology, Clinic of Medicine St. Olav's Hospital, Trondheim University Hospital  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Are H.","family":"Pripp","sequence":"additional","affiliation":[{"name":"Oslo Center of Biostatistics and Epidemiology, Research Support Services Oslo University Hospital  Oslo Norway"},{"name":"Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid H.","family":"Liavaag","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology S\u00f8rlandet Hospital Arendal  Arendal Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7670-400X","authenticated-orcid":false,"given":"Nora","family":"Johansen","sequence":"additional","affiliation":[{"name":"Research Unit S\u00f8rlandet Hospital HF  Kristiansand Norway"},{"name":"Department of Obstetrics and Gynecology S\u00f8rlandet Hospital Arendal  Arendal Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Folkehelseinstituttet.Causes of death & Life expectancy [Causes of death & Life expectancy in Norway]. 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