National Assessment of Advancing Age on Perioperative Morbidity and Length of Stay Associated With Minimally Invasive Sacrocolpopexy. Issue 6 (November 2016)

• Record Type: Journal Article
• Authors: Chaudhry, Zaid; Cohen, Seth Ashley; Tarnay, Christopher
• Is Part Of: Female pelvic medicine & reconstructive surgery. Volume 22:Issue 6(2016:Nov./Dec.)
• Publication Date: 2016-11
• Subjects: geriatrics -- patient outcomes assessment -- pelvic organ prolapse -- sacrocolpopexy -- National Surgical Quality Improvement Program; Pelvis -- Diseases -- Periodicals; Pelvis -- Surgery -- Periodicals; Genital Diseases, Female -- surgery -- Periodicals; Urologic Diseases -- surgery -- Periodicals; Colonic Diseases -- surgery -- Periodicals; Rectal Diseases -- surgery -- Periodicals; Surgical Procedures, Operative -- methods -- Periodicals; 616.6
• DOI: 10.1097/SPV.0000000000000319
• Languages: English
• ISSNs: 2151-8378

Abstract

Abstract : Objective: The aim of the study was to assess the impact of age on 30-day perioperative complications and length of stay (LOS) for minimally invasive sacrocolpopexy (MISC) using a national database. Methods: We performed an institutional review board–exempt retrospective analysis of prospectively collected data, using the National Surgical Quality Improvement Program database to analyze MISC performed at participating hospitals from 2010 to 2013. Age was stratified into the following 5 categories: younger than 60, 60 to 64, 65 to 69, 70 to 74, and 75 years or older. Complications were tabulated on the basis of available categories and were assessed using logistic multivariate regression. Length of stay was deemed abnormal if 3 days or more. Results: A total of 1201 patients were identified as having undergone MISC. Mean (SD) patients age was 61.3 (11.1) years. Most patients had an American Society of Anesthesiologists (ASA) class of 2 (68.3%) or an ASA class of 3 (23.6%). Older patients had a significantly higher ASA class and lower body mass index. The most common complications were urinary tract infection (3.4%), readmission (2.7%), and return to the operating room (1.5%). Urinary tract infection ( P = 0.93), readmission ( P = 0.38), and return to the operating room ( P = 0.17) were not significantly different between age groups. Older patients did not have greater odds of having an LOS of 3 days or more versus 1 day or 0 to 2 days. Conclusions: Returns to the operating room, readmission, and urinary tract infection were the most common adverse events and did not differ between age groups. Older patients did not have greater odds of having an increased LOS. Minimally invasive sacrocolpopexy seems to be safe among appropriately selected elderly patients. Abstract : Older patients do not appear to have higher rates of adverse perioperative outcomes or increased odds of a prolonged length of hospital stay after undergoing minimally invasive sacrocolpopexy.