The effect of age on postoperative morbidity in women undergoing urogynecologic surgery

Objectives The objectives of this study were to estimate the effect of older age on postoperative morbidity and to assess other factors associated with postoperative complications after urogynecologic surgery. Methods We conducted a retrospective cohort study of 508 women who underwent pelvic floor reconstructive surgery between March 2011 and June 2013. Our 2 cohorts were based on age - women younger than 65 years and women aged 65 years or older. Our primary outcome was clinically significant postoperative complications defined as Dindo-Clavien grade greater than or equal to 2. We compared the risk of postoperative morbidity between the cohorts and constructed a logistic regression analysis to adjust for potential confounders. Results Of the 508 patients, 300 (59.1%) were in the younger cohort and 208 (40.9%) were in the older cohort. For our primary outcome, we found that older women had a significantly higher rate of clinically significant postoperative complications (12.5% vs 6.7%, P = 0.02). In a multivariate logistic regression model that included advanced prolapse, smoking status, Charlson Comorbidity Index, body mass index, and operative time, older age remained significantly associated with greater postoperative morbidity (odds ratio, 2.06; 95% confidence interval, 1.03-4.11). The length of surgery in hours was also associated with greater morbidity (odds ratio, 1.47; 95% confidence interval, 1.14-1.66). Conclusions Women aged 65 years and older who underwent urogynecologic surgery had a higher risk of clinically significant postoperative complications based on the Dindo-Clavien Scale when compared with women younger than 65 years.