OBJECTIVE: To evaluate whether preoperative markers of functional status predict postoperative functional outcomes in older women undergoing surgery for pelvic organ prolapse (POP).
METHODS: Prospective cohort study of women aged 60 years or older who underwent surgery for prolapse. Preoperative functional status was measured using number of functional limitations (such as difficulty walking or climbing), American Society of Anesthesiologists class, anemia, and history of recent weight loss. Our primary outcome was the number of postoperative functional limitations and secondary outcomes were failure to return to baseline functional status and length of stay after surgery. We determined the association of preoperative functional status markers with postoperative outcomes using univariable and multivariable regression.
RESULTS: In 127 women, presence of a preoperative functional limitation was a significant predictor of a 0.55 (95% confidence interval [CI] 0.36-0.74) increase in the number of postoperative functional limitations after controlling for age, number of preoperative functional limitations, comorbidities, depression, surgeon, type of procedure, and complications (P< .001). History of recent weight loss and anemia increased risk for failure to return to baseline functional status after controlling for surgeon, type of surgery, and complications (relative risk 2.44, 95% CI 1.26-4.71 and relative risk 2.72, 95% CI 1.29-5.75), respectively). Preoperative markers associated with longer length of stay after surgery were American Society of Anesthesiologists class III (0.83 days, 95% CI 0.20-1.46) and history of weight loss (0.84 days, 95% CI 0.13-1.54).
CONCLUSION: Preoperative markers of functional status are useful in predicting short-term postoperative functional outcomes in older women undergoing surgery for POP.
Written by:
Greer JA, Harvie HS, Andy UU, Smith AL, Northington GM, Arya LA. Are you the author?
Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, and the Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Women's Health Department, Division of Urogynecology, Naval Medical Center, Portsmouth, Virginia; Department of Obstetrics, Division of Female Pelvic Medicine & Reconstructive Surgery, Emory University School of Medicine, Atlanta, Georgia.
Reference: Obstet Gynecol. 2015 Mar;125(3):551-8.
doi: 10.1097/AOG.0000000000000644
PubMed Abstract
PMID: 25730215