title: Risk index for pelvic organ prolapse based on established individual risk factors.
abstract: OBJECTIVE
  To identify known risk factors for pelvic organ prolapse (POP) in a hospital cohort and to develop a prolapse risk index (PRI).
  
  
  METHODS
  Risk factors for POP were recorded in women who underwent surgery with symptomatic POP (n = 500) or non-POP gynaecological conditions (n = 236). Descriptive statistics were determined by Chi-squared and Mann-Whitney U tests. Stepwise multivariate regression analysis was performed for all patients and subgroups by age (<60 and ≥60 years). Primary outcome measures were variables with the strongest impact on prolapse and PRI development. Secondary: specificity, sensitivity, positive and negative predictive values (PPV and NPV, respectively), and Cohen's kappa statistic (κ).
  
  
  RESULTS
  Stepwise multivariate regression analysis (n = 736) showed difficult obstetric history [odds ratio (OR) 10.04], family history of POP (OR 7.28), and ≥10 years since menopause (OR 4.53) were independent risk factors for prolapse (P < 0.001). When one of the three variables with the strongest influence on POP development was present, the PRI for all women showed a PPV of 82%, NPV of 68%, and κ of 0.47 for predicting symptomatic POP requiring treatment. In women under 60 years (n = 349), logistic regression revealed difficult obstetric history (OR 9.108), positive family history (OR 8.016), and body mass index (OR 2.274) as independent risk factors.
  
  
  CONCLUSIONS
  Eighty-seven percent of our patient cohort with symptomatic POP requiring therapy could be identified by the PRI, which may be useful for counselling and education.
authors: Department of Gynaecology and Obstetrics, Jena University Hospital, Friedrich-Schiller-University Jena, Bachstraße 18, 07743, Jena, Germany. anke.mothes@med.uni-jena.de.
authors: A R
authors: AR
authors: Mothes
authors: Department of Gynaecology and Obstetrics, Jena University Hospital, Friedrich-Schiller-University Jena, Bachstraße 18, 07743, Jena, Germany.
authors: M P
authors: MP
authors: Radosa
authors: Department of General, Visceral, and Vascular Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany.
authors: A
authors: A
authors: Altendorf-Hofmann
authors: Department of Gynaecology and Obstetrics, Jena University Hospital, Friedrich-Schiller-University Jena, Bachstraße 18, 07743, Jena, Germany. ingo.runnebaum@med.uni-jena.de.
authors: I B
authors: IB
authors: Runnebaum
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008593:Menopause; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
keywords: Pelvic organ prolapse; Prolapse risk index; Risk factors