Evidence map›Paper›PMID 35662357›Full record

ArticleInternational urogynecology journal2022

Adverse outcomes after minimally invasive surgery for pelvic organ prolapse in women 65 years and older in the United States.

C Emi Bretschneider, Charles D Scales, Oyomoare Osazuwa-Peters, David Sheyn, Vivian Sung

Open access · greenAbstract read
In one paragraph

Article in International urogynecology journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 24% 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, 7 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

C Emi BretschneiderDivision of Female Pelvic Medicine and Reconstructive Surgery, Departments of Obstetrics & Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. carol.bretschneider@nm.org.ORCID 0000-0002-8129-9643
Charles D ScalesDepartments of Surgery (Urology) and Population Health Science, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Oyomoare Osazuwa-PetersDepartment of Population Health Science, Duke University School of Medicine, Durham, NC, USA.
David SheynDivision of Female Pelvic Medicine and Reconstructive Surgery, Urology Institute, University Hospitals, Cleveland, OH, USA.
Vivian SungDepartment Obstetrics and Gynecology, Alpert Medical School at Brown University, Providence, RI, USA.
Duke University · USBrown University · USInstitute for Female Pelvic Medicine and Reconstructive Surgery · USNorthwestern University · US

Funding

UrogynCREST ProgramR25HD094667 · NICHD · DUKE UNIVERSITY · PI Cindy Amundsen · 2019 to 2026
$1.2M
NICHD NIH HHS R25 HD094667
6 · The paper itself

Abstract

introduction and hypothesisTo describe complications at the time of surgery, 90-day readmission and 1-year reoperation rates after minimally invasive pelvic organ prolapse (POP) in women > 65 years of age in the US using Medicare 5% Limited Data Set (LDS) Files.

methodsMedicare is a federally funded insurance program in the US for individuals 65 and older. Currently, 98% of individuals over the age of 65 in the US are covered by Medicare. We identified women undergoing minimally invasive POP surgery, defined as laparoscopic or vaginal surgery, in the inpatient and outpatient settings from 2011-2017. Patient and surgical characteristics as well as adverse events were abstracted. We used logistic regression for complications at index surgery and Cox proportional hazards regression models for time to readmission and time to reoperations.

resultsA total of 11,779 women met inclusion criteria. The mean age was 72 (SD ± 8) years; the majority were White (91%). Most procedures were vaginal (76%) and did not include hysterectomy (68%). The rate of complications was 12%; vaginal hysterectomy (aOR 2.4, 95% CI 2.2-2.7) was the factor most strongly associated with increased odds of complications. The 90-day readmission rate was 7.3%. The most common reason for readmission was infection (2.0%), three quarters of which were urinary tract infections. Medicaid eligibility (aHR 1.5, 95% CI 1.3-1.8) and concurrent sling procedures (aHR 1.2, 95% CI 1.04-1.4) were associated with a higher risk of 90-day readmission. The 1-year reoperation rate was 4.5%. The most common type of reoperation was a sling procedure (1.8%). Obliterative POP surgery (aHR 0.6, 95% CI 0.4-0.9) was associated with a lower risk of reoperation than other types of surgery.

conclusionsUS women 65 years and older who are also eligible to receive Medicaid are at higher risk of 90-day readmission following minimally invasive surgery for POP with the most common reason for readmission being UTI.

Indexed as

Pelvic Organ ProlapsePostoperative ComplicationsAgedFemaleGynecologic Surgical ProceduresHumansHysterectomy, VaginalMedicareMinimally Invasive Surgical ProceduresReoperationRetrospective StudiesUnited StatesComplicationsMinimally invasive surgeryPelvic organ prolapseReadmissionReoperation

Identifiers

PMID35662357
PMCPMC9724747
OpenAlexW4281720250

What OpenQuestion holds

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Registered trials

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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.