Evidence map›Paper›PMID 27824746›Full record

ArticleObstetrics and gynecology2016

Readmission and Prolapse Recurrence After Abdominal and Vaginal Apical Suspensions in Older Women.

Tatiana V D Sanses, Jan M Hanley, Peter Zhang, Holly E Richter, Steven R Gambert, Chris S Saigal

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PubMed Full text at PMC Publisher
In one paragraph

Article in Obstetrics and gynecology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Tatiana V D SansesUniversity of Maryland School of Medicine, Baltimore, Maryland; RAND Corporation, Santa Monica, California; the University of Alabama at Birmingham School of Medicine, Birmingham, Alabama; and Geffen School of Medicine at University of California, Los Angeles, California.
Jan M Hanley
Peter Zhang
Holly E Richter
Steven R Gambert
Chris S Saigal
University of Maryland, Baltimore · US

Funding

University of Maryland Claude D. Pepper Older Americans Independence Center (UM-OAIC)P30AG028747 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI Stephen L. Seliger · 2006 to 2026
$28.9M
Maryland's Organized Research Effort in Women's Health (MORE-WH)K12HD043489 · NICHD · UNIVERSITY OF MARYLAND BALTIMORE · PI TRACY, J. KATHLEEN · 2002 to 2016
$7.0M
Urinary Incontinence, Mobility, Muscle Function in Older WomenR03AG053281 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI SANSES, TATIANA V.D. · 2016 to 2017
$231k
NIA NIH HHS P30 AG028747NIA NIH HHS R03 AG053281NICHD NIH HHS K12 HD043489NLM NIH HHS HHSN276201200016C
6 · The paper itself

Abstract

objectiveOur objective was to evaluate 30-day readmission, 12-month prolapse recurrence, and complications after apical surgeries in older women.

methodsA retrospective cohort study was conducted using 2002-2011 Medicare data in women 65 years or older who underwent abdominal sacrocolpopexy with synthetic mesh, vaginal uterosacral, or sacrospinous colpopexy with 12 months follow-up. Vaginal mesh procedures were excluded. The primary outcome was 30-day inpatient readmission. Secondary outcomes were complications and prolapse recurrence, defined as either reoperation or pessary insertion. We used Pearson χ, Fisher exact tests, and analyses of variance to examine difference between surgical treatment groups. Odds ratios (ORs) utilizing Charlson Comorbidity Index, age, race, and procedure type were calculated to assess the differences in the outcomes probability.

resultsOf 3,015 women, 863 underwent abdominal sacrocolpopexy, 510-uterosacral and 1,642-sacrospinous ligament suspensions. The 30-day readmission was 7.4% (95% confidence interval [CI] 5.7-9.2%; OR 2.4, 95% CI 1.7-3.5, P<.01) after abdominal sacrocolpopexy and 4.5% (95% CI 2.7-6.3%; OR 1.3, 95% CI 0.8-2.1, P=.3) after uterosacral compared with 3.5% (95% CI 2.6-4.4% P<.01) after sacrospinous ligament suspensions. Prolapse recurrence did not differ between the groups (8.2%, 95% CI 6.4-10.1%; 10.6%, 95% CI 7.9-13.3%; and 9.9%, 95% CI 8.4-11.3%, P=.3, respectively). Women had 30-day gastrointestinal complications (6.1%, 95% CI 4.5-7.7%; 1.2%, 95% CI 0.2-2.1%; and 1.1%, 95% CI 0.6-1.6%, P<.01), surgical site infections (5.9%, 95% CI 4.3-7.5%; 3.1%, 95% CI 1.6-4.7%; and 3.7%, 95% CI 2.8-4.6%, P=.01), genitourinary complications (10.9%, 95% CI 8.8-13%; 17.7%, 95% CI 14.3-21%; and 13.6%, 95% CI 12-15.3%, P<.01), and medical complications (7.4%, 95% CI 5.7-9.2%; 7.8%, 95% CI 5.5-10.2%; and 4.4%, 95% CI 3.4-5.4%, P<.01; all after abdominal sacrocolpopexy, uterosacral, and sacrospinous ligament suspensions, respectively).

conclusionVaginal apical suspensions compared with abdominal sacrocolpopexy with synthetic mesh are associated with lower rates of postoperative 30-day readmission without an increase in prolapse recurrence among older women.

Indexed as

Patient ReadmissionAgedAged, 80 and overFemaleFemale Urogenital DiseasesGastrointestinal DiseasesHumansLigamentsPelvic Organ ProlapsePostoperative ComplicationsRecurrenceRetrospective StudiesSacrumSurgical MeshSurgical Wound InfectionVagina

Identifiers

PMID27824746
PMCPMC5121077
OpenAlexW2593034041

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.