title: Gynaecological Prolapse Surgery in Very Old Female Patients: A Case-Control Study on Co-Morbidity and Surgical Complications.
abstract: BACKGROUND
  The aim of this study is to compare very elderly female patients with a younger control group after prolapse surgery with regard to co-morbidity and complications.
  
  
  METHODS
  In a case-control design, the consecutive data of patients after prolapse surgery at the age of over 80 years and those of a control group were analysed by means of the Clavien-Dindo (CD) classification of surgical complications, the Charlson Comorbidity Index and the Cumulative Illness Rating Scale Geriatrics (CIRS-G). Statistics: Student's t, Fisher's exact and Mann-Whitney U tests.
  
  
  RESULTS
  The analysis comprised n = 57 vs. n = 60 operations. In the very elderly patients there was often a grade IV prolapse (p < 0.001), apical fixations were more frequent (p < 0.001), but the operating times were not different. In the very elderly patients 21 % CD II+III complications were observed, in the control group 6.6 % (p = 0.031). No CD IV and V complications occurred in either group, the duration of inpatient stay amounted to 5 (± 1) vs. 4.1 (± 0.8; p < 0.001) days, the very elderly patients needed an inpatient follow-up more frequently (p < 0.001). The co-morbidities of the very elderly patients differed from those of the control group in number (median 2.0 vs. 1.5; p < 0.001), in CIRS-G (4.1 ± 2.2 vs. 2.4 ± 1.7; p < 0.01) and in Charlson Index (1.6 ± 1.6 vs. 0.5 ± 0.7; p < 0.001).
  
  
  CONCLUSIONS
  A prolapse in very elderly women can be safely managed by surgery. In no case did the complications require intensive care treatment nor were they life-threatening, but they did lead to a longer duration of hospital stay and more frequently to further treatment geriatric or inpatient internal medicine facilities.
authors: Universitätsfrauenklinik, Friedrich-Schiller-Universität, Jena.
authors: A R
authors: AR
authors: Mothes
authors: Institut für Medizinische Statistik, Informatik und Dokumentation, Friedrich-Schiller-Universität, Jena.
authors: T
authors: T
authors: Lehmann
authors: Klinik für Geriatrie, Universitätsklinikum, Friedrich-Schiller-Universität, Jena.
authors: A
authors: A
authors: Kwetkat
authors: Universitätsfrauenklinik, Friedrich-Schiller-Universität, Jena.
authors: M P
authors: MP
authors: Radosa
authors: Universitätsfrauenklinik, Friedrich-Schiller-Universität, Jena.
authors: I B
authors: IB
authors: Runnebaum
keywords: Clavien-Dindo classification system; co-morbidity; prolapse surgery; surgical complications; very elderly people