C Emi Bretschneider1,2, David Sheyn3,4, Sangeeta Mahajan3,4, Katie Propst5, Beri Ridgeway5. 1. Center for Urogynecology and Pelvic Floor Disorders, OB/GYN & Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA. carol.bretschneider@nm.org. 2. , Chicago, USA. carol.bretschneider@nm.org. 3. Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. 4. Case Western Reserve University School of Medicine, Cleveland, OH, USA. 5. Center for Urogynecology and Pelvic Floor Disorders, OB/GYN & Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: The primary aim of this study was to compare differences in complication rates across different types of vaginal colpopexy using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. METHODS: Patients who underwent intra- or extraperitoneal vaginal colpopexy with or without concurrent hysterectomy were identified in the 2014-2016 NSQIP database using Current Procedural Terminology codes. Patient demographics, preoperative comorbidities, American Society of Anesthesiologists (ASA) classification system scores, and total operating time were obtained. NSQIP-tracked 30-day codes were used to determine the complication, reoperation, and readmission rates. RESULTS: A total of 9546 colpopexies were performed during the study period. The mean age was 62 ± 12 years, and the mean body mass index (BMI) was 28 ± 6 kg/m2. The majority of patients were white (73%) with an ASA class of 2 (65%). The overall rate of postoperative complications was 10.5%. The most common complications were urinary tract infections (UTI) (5.1%), transfusion (1.0%), and superficial surgical site infection (0.7%). Excluding UTI, the rate of postoperative complications was 5.4%. After performing multivariable logistic regression, higher ASA class (class 3: aOR 1.69, 95% CI 1.16-2.51; class 4: aOR 3.98, 95% CI 1.51, 9.30) and extraperitoneal colpopexy with hysterectomy were independently associated with a higher odds of experiencing a non-UTI postoperative complication (aOR1.43, 95% CI 1.10, 1.84). Minority race was also independently associated with higher odds of experiencing a non-UTI postoperative complication (aOR 1.33, 95% CI 1.15, 1.52). CONCLUSION: One in ten women undergoing vaginal colpopexy experienced a postoperative complication. Minority race and extraperitoneal colpopexy with concurrent hysterectomy were independently associated with an increased risk of a non-UTI postoperative complication.
INTRODUCTION AND HYPOTHESIS: The primary aim of this study was to compare differences in complication rates across different types of vaginal colpopexy using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. METHODS:Patients who underwent intra- or extraperitoneal vaginal colpopexy with or without concurrent hysterectomy were identified in the 2014-2016 NSQIP database using Current Procedural Terminology codes. Patient demographics, preoperative comorbidities, American Society of Anesthesiologists (ASA) classification system scores, and total operating time were obtained. NSQIP-tracked 30-day codes were used to determine the complication, reoperation, and readmission rates. RESULTS: A total of 9546 colpopexies were performed during the study period. The mean age was 62 ± 12 years, and the mean body mass index (BMI) was 28 ± 6 kg/m2. The majority of patients were white (73%) with an ASA class of 2 (65%). The overall rate of postoperative complications was 10.5%. The most common complications were urinary tract infections (UTI) (5.1%), transfusion (1.0%), and superficial surgical site infection (0.7%). Excluding UTI, the rate of postoperative complications was 5.4%. After performing multivariable logistic regression, higher ASA class (class 3: aOR 1.69, 95% CI 1.16-2.51; class 4: aOR 3.98, 95% CI 1.51, 9.30) and extraperitoneal colpopexy with hysterectomy were independently associated with a higher odds of experiencing a non-UTI postoperative complication (aOR1.43, 95% CI 1.10, 1.84). Minority race was also independently associated with higher odds of experiencing a non-UTI postoperative complication (aOR 1.33, 95% CI 1.15, 1.52). CONCLUSION: One in ten women undergoing vaginal colpopexy experienced a postoperative complication. Minority race and extraperitoneal colpopexy with concurrent hysterectomy were independently associated with an increased risk of a non-UTI postoperative complication.
Entities:
Keywords:
Complications; Prolapse; Vaginal surgery
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