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Laparoscopic Non-Mesh Cerclage Pectopexy with Uterine Preservation for Pelvic Organ Prolapse
Published on: October 25, 2024
Delirium After Prolapse Surgery Increases Complications: National Cohort Study
Anna Bales1, Christopher X Hong2, Mary F Ackenbom2
1University of Virginia School of Medicine, Charlottesville, VA, USA.
International Urogynecology Journal
|June 16, 2026
Summary
Postoperative delirium (POD) significantly increases adverse events after prolapse surgery in older women. Recognizing POD risks is crucial for better patient counseling and outcomes.
Area of Science:
- Geriatric Medicine
- Surgical Outcomes
- Neuroscience
Background:
- Postoperative delirium (POD) is a common complication in older adults after surgery.
- The impact of POD on outcomes following prolapse surgery remains unclear.
- Older adults undergoing prolapse surgery are at risk for altered mentation.
Purpose of the Study:
- To investigate the association between POD and adverse events (AEs) after prolapse surgery in women aged 75 years and older.
- To determine if POD increases the likelihood of reoperation or discharge to a skilled nursing facility (SNF).
- To quantify the risk of AEs associated with POD in this patient population.
Main Methods:
- Retrospective cohort study utilizing the National Surgical Quality Improvement Program (NSQIP) data registry.
- Inclusion criteria: women aged ≥75 years who underwent prolapse surgery between 2021 and 2023.
- Primary outcome: composite 30-day AE. Multivariable logistic regression was employed for analysis.
Main Results:
- Of 1766 women, 4.9% were diagnosed with POD. Patients with POD were older and more likely to have baseline dementia.
- POD was significantly associated with increased rates of reoperation (5.8% vs. 1.6%) and discharge to SNF (4.6% vs. 0.9%).
- Multivariable analysis revealed POD increased adjusted odds for composite AEs (OR 2.11), reoperation (OR 3.41), and SNF discharge (OR 3.71) within 30 days.
Conclusions:
- Postoperative delirium is linked to a higher incidence of adverse events in older women undergoing prolapse surgery.
- These findings underscore the importance of considering POD risks in preoperative discussions.
- Enhanced perioperative care and counseling for older adults undergoing reconstructive pelvic surgery are recommended.
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