Associations Between Short-Term Postoperative Outcomes and Immunocompromised Status in Patients Undergoing...

Area of Science:

• Urogynecology
• Surgical Outcomes Research
• Immunology

Background:

• Sacrocolpopexy (SCP) is a surgical procedure for pelvic organ prolapse.
• Data on perioperative outcomes for immunocompromised women undergoing SCP are limited.
• Immunosuppression may affect surgical recovery and increase complication risks.

Purpose of the Study:

• To compare 30-day perioperative morbidity in immunocompromised versus non-immunocompromised women undergoing SCP.
• To determine if immunocompromised status is associated with worse composite postoperative outcomes after SCP.

Main Methods:

• Retrospective cohort study of 13,505 female patients undergoing SCP (2012-2017).
• Identified immunocompromised status and outcomes using the American College of Surgeons-National Surgical Quality Improvement Project database.
• Utilized marginal standardization to estimate the association between immunocompromised status and a composite outcome of 30-day readmission, reoperation, or severe adverse events.

Main Results:

• 19.4% of patients were identified as immunocompromised, with diabetes and smoking being the most common causes.
• The composite adverse outcome occurred in 7.3% of immunocompromised women versus 4.6% of non-immunocompromised women.
• Immunocompromised women had a 54% increased relative risk of adverse outcomes (RR=1.54; 95% CI: 1.31, 1.82) after adjustment.

Conclusions:

• Immunocompromised status significantly increases the risk of 30-day perioperative complications after sacrocolpopexy.
• Diabetes and smoking are prevalent contributors to immunocompromised status in this population.
• These findings highlight the need for careful preoperative assessment and management of immunocompromised patients undergoing SCP.