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Published on: October 25, 2024
Age and Perioperative Outcomes Following Minimally Invasive Sacrocolpopexy
Samantha Erin Neal1, Sarah Ashmore2, Jinxuan Shi2
1Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL.
Importance:
Literature surrounding the effect of age on perioperative outcomes following minimally invasive sacrocolpopexy (MI-SCP) is limited and conflicting.
Objective:
The objective of this study was to determine the effect of age on postoperative complications following MI-SCP, utilizing a large, national database.
Study Design:
This was a retrospective cohort study using the 2014-2021 American College of Surgeons National Surgical Quality Improvement Program database to determine the effect of age on postoperative complications following MI-SCP. Women undergoing robotic and laparoscopic sacrocolpopexy for prolapse were included, and surgical procedures were identified using Current Procedural Terminology codes. Our primary outcome was the 30-day postoperative complication rate. Women were stratified into 2 cohorts: (1) 65 years or older and (2) younger than 65 years. Standard group comparisons were performed. A multivariable logistic regression was completed to determine if age affected the postoperative complication rate after accounting for other variables.
Results:
A total of 6,794 women underwent MI-SCP; 3,726 (54.8%) were younger than 65 years, and 3,068 (45.2%) were 65 years or older. Overall, the 30-day postoperative complication rate following MI-SCP was 5.02%, and women 65 years or older were less likely to experience a postoperative complication compared with women younger than 65 years (3.98% vs 5.88%, P <0.001). In logistic regression, age younger than 65 years was associated with increased odds of 30-day postoperative complications (adjusted odds ratio [aOR], 1.56; 95% CI, 1.22-2.00). Class 3 obesity (aOR, 1.87) and longer length of stay (aOR, 1.13) were also associated with increased odds of postoperative complications.
Conclusions:
Our findings suggest that age 65 years or older is not associated with increased postoperative complications following MI-SCP.
Insights
Older women (65+) undergoing minimally invasive sacrocolpopexy (MI-SCP) have fewer postoperative complications than younger patients. Age is not a risk factor for complications after MI-SCP surgery.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Geriatric Surgery
Background:
- Literature on age-related perioperative outcomes for minimally invasive sacrocolpopexy (MI-SCP) is scarce and contradictory.
- Understanding the impact of age on postoperative outcomes is crucial for patient counseling and surgical planning.
Purpose of the Study:
- To investigate the effect of patient age on 30-day postoperative complications following MI-SCP.
- To analyze a large national database to provide robust evidence on age and MI-SCP outcomes.
Main Methods:
- Retrospective cohort study using the 2014-2021 American College of Surgeons National Surgical Quality Improvement Program database.
- Included women undergoing robotic or laparoscopic sacrocolpopexy for pelvic organ prolapse.
- Compared postoperative complication rates between women aged 65 years and older versus those younger than 65 years, using multivariable logistic regression.
Main Results:
- A total of 6,794 women were analyzed; 45.2% were 65 years or older.
- The overall 30-day complication rate was 5.02%.
- Women aged 65 and older had a lower complication rate (3.98%) compared to younger women (5.88%, P < 0.001). Age younger than 65 was associated with increased odds of complications (aOR, 1.56).
Conclusions:
- Advanced age (65 years and older) is not associated with increased postoperative complications after minimally invasive sacrocolpopexy.
- Younger age (<65 years) was identified as a predictor of increased postoperative complications.
- Factors such as Class 3 obesity and longer hospital stay also correlated with higher complication rates.
