Short-term postoperative functional outcomes in older women undergoing prolapse surgery.
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).


CONCLUSIONS
Preoperative markers of functional status are useful in predicting short-term postoperative functional outcomes in older women undergoing surgery for POP.


METHODS
: II.
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; the Women's Health Department, Division of Urogynecology, Naval Medical Center, Portsmouth, Virginia; and the Department of Obstetrics, Division of Female Pelvic Medicine & Reconstructive Surgery, Emory University School of Medicine, Atlanta, Georgia.
Joy A
JA
Greer
Heidi S
HS
Harvie
Uduak U
UU
Andy
Ariana L
AL
Smith
Gina M
GM
Northington
Lily A
LA
Arya
D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome