Related Experiment Videos
You're How Old? Correlating Perioperative Complication Risk in Octogenarians Undergoing Colpocleisis for Pelvic Organ
Romina Sifuentes1, Birte Johanna Wolff2, Hayley Catherine Barnes2
1From the Loyola University Chicago Stritch School of Medicine.
Female Pelvic Medicine & Reconstructive Surgery
|July 30, 2019
Summary
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator does not accurately predict complications for elderly women undergoing colpocleisis surgery. Actual complication rates were significantly higher than predicted, indicating a need for calculator refinement.
Area of Science:
- Geriatric Surgery
- Urogynecology
Background:
- Colpocleisis is a surgical option for pelvic organ prolapse in elderly, non-sexually active women.
- The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator estimates perioperative risks.
Purpose of the Study:
- To evaluate the correlation between ACS NSQIP-calculated risk and actual perioperative complications in octogenarian women undergoing colpocleisis.
Main Methods:
- Retrospective chart review of 126 women aged 80+ who underwent colpocleisis between 2007-2017.
- Comorbidities were input into the ACS NSQIP calculator, and predicted risks were compared to observed complications.
Main Results:
- The observed complication rate was 28.6%, significantly higher than the predicted 4.3%.
- Urinary tract infections were the most common complication (32/36).
- The NSQIP calculator showed poor concordance (57%) with actual outcomes, with low sensitivity (66.7%) and specificity (53.3%).
- Antiplatelet medication use and hypertension were associated with higher-than-predicted complications.
Conclusions:
- Serious complication rates in octogenarians undergoing colpocleisis are low.
- The ACS NSQIP risk calculator demonstrates limited predictive accuracy for this patient population.
- Further development of the ACS NSQIP database may enhance its predictive capabilities.