Hong Christopher X, Halani Priyanka K, Gutkind Naomi, Harvie Heidi S, Arya Lily A, Andy Uduak U
Division of Urogynecology, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 5 Dulles, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, 19104, PA, USA.
Int Urogynecol J. 2020 Jul;31(7):1463-1470. doi: 10.1007/s00192-019-04180-9. Epub 2020 Jan 3.
Pelvic floor disorders are common among and disproportionately affect older women. There are limited data regarding perioperative adverse events in older women undergoing robot-assisted sacrocolpopexy (RASC) specifically. The aim of this study was to compare the rate of perioperative adverse events in younger (age <65 years) versus older (age >65 years) women who underwent RASC.
We conducted a retrospective cohort study of women who underwent RASC between 2013 and 2018. Postoperative adverse events were categorized according to the Clavien-Dindo classification. Our primary outcome was the rate of intraoperative adverse events and postoperative adverse events with Clavien-Dindo grade II or greater. Outcomes were compared using univariate and multivariate analysis.
Of the 327 patients included in the study, 227 were <65 years of age and 100 were ≥65 years of age. Women ≥65 years of age had higher rates of hypertension, higher American Society of Anesthesiologist (ASA) class, and higher Charlson Comorbidity Index (CCI) scores compared with women <65 years of age; these were not associated with increased likelihood of adverse events. The overall rate of any perioperative adverse event was 18.3%. There was no statistically significant difference in the overall rate of perioperative adverse events between younger and older women (18.5% vs 18.0%, p = 0.91).
There is no difference in rate of adverse events between women ≥65 years of age undergoing RASC and their younger counterparts.
盆底功能障碍在老年女性中很常见，且对她们的影响尤为严重。关于接受机器人辅助骶骨阴道固定术（RASC）的老年女性围手术期不良事件的数据有限。本研究的目的是比较接受RASC的年轻女性（年龄<65岁）和老年女性（年龄>65岁）围手术期不良事件的发生率。
我们对2013年至2018年间接受RASC的女性进行了一项回顾性队列研究。术后不良事件根据Clavien-Dindo分类进行分类。我们的主要结局是术中不良事件以及Clavien-Dindo分级为II级或更高的术后不良事件的发生率。采用单因素和多因素分析比较结局。
在纳入研究的327例患者中，227例年龄<65岁，100例年龄≥65岁。与年龄<65岁的女性相比，年龄≥65岁的女性高血压发生率更高、美国麻醉医师协会（ASA）分级更高、Charlson合并症指数（CCI）得分更高；这些与不良事件发生可能性增加无关。任何围手术期不良事件的总体发生率为18.3%。年轻女性和老年女性围手术期不良事件的总体发生率无统计学显著差异（18.5%对18.0%，p = 0.91）。
接受RASC的年龄≥65岁的女性与年轻女性在不良事件发生率方面没有差异。
