Female Pelvic Med Reconstr Surg. 2021 Jun 1;27(6):e542-e548. doi: 10.1097/SPV.0000000000000988.
The aim of the study was to determine the effect of increasing age on postoperative admission, readmission, and complications for patients 60 years and older who underwent a synthetic or autologous sling procedure for stress incontinence.
A retrospective cohort study of surgical cases from 2012 to 2017 from the American College of Surgeons National Surgical Quality Improvement Program database was conducted. Eligible patients were at least 60 years old and underwent an isolated sling procedure for stress incontinence identified by Current Procedural Terminology code 57288. Baseline demographics, preoperative comorbidities, and postoperative complications were obtained. Risk ratios (RRs) and 95% confidence intervals were calculated using log-binomial regressions.
Of 3,960 eligible patients, 634 (16.0%) were admitted postoperatively. Admission rates differed across age groups (P = 0.04). For example, compared with patients aged 60-64 years, those aged 70-74 years had 1.3 times the risk of admission (95% confidence interval, 1.04-1.6). Other risk factors for admission included diabetes (RR, 1.3) and hypertension (RR, 1.2). Patients who had general anesthesia had 6.3 times the risk of admission compared with those who had monitored anesthesia/intravenous sedation. There were 72 patients (1.8%) readmitted within 30 days. There was no association between age and readmission. Risk factors for readmission included diabetes (RR, 1.8), bleeding disorders (RR, 3.4), severe chronic obstructive pulmonary disease (RR, 3.7), and congestive heart failure (RR, 11.3). There were 192 complications (4.8%), including 45 major complications (1.1%).
Among patients 60 years and older, the risk of postoperative admission and readmission for patients undergoing a synthetic or autologous sling procedure is low and complications are uncommon.
本研究旨在探讨 60 岁及以上因压力性尿失禁接受合成或自体吊带手术的患者，年龄增长对术后住院、再入院和并发症的影响。
对美国外科医师学会国家手术质量改进计划数据库 2012 年至 2017 年的手术病例进行回顾性队列研究。纳入标准为年龄至少 60 岁，接受单纯吊带手术治疗压力性尿失禁（经当前操作术语代码 57288 识别）。获取基线人口统计学资料、术前合并症和术后并发症。采用对数二项式回归计算风险比（RR）和 95%置信区间。
在 3960 例符合条件的患者中，634 例（16.0%）术后住院。不同年龄组的住院率存在差异（P = 0.04）。例如，与 60-64 岁患者相比，70-74 岁患者的住院风险增加 1.3 倍（95%置信区间，1.04-1.6）。其他住院风险因素包括糖尿病（RR，1.3）和高血压（RR，1.2）。与接受监测麻醉/静脉镇静的患者相比，接受全身麻醉的患者的住院风险增加 6.3 倍。术后 30 天内有 72 例（1.8%）患者再入院。年龄与再入院无关联。再入院的风险因素包括糖尿病（RR，1.8）、出血性疾病（RR，3.4）、严重慢性阻塞性肺疾病（RR，3.7）和充血性心力衰竭（RR，11.3）。共发生 192 例（4.8%）并发症，包括 45 例重大并发症（1.1%）。
在 60 岁及以上患者中，接受合成或自体吊带手术的患者术后住院和再入院的风险较低，并发症罕见。
