Frailty and Acute Postoperative Urinary Retention in Older Women Undergoing Pelvic Organ Prolapse Surgery.
Frailty and Acute Postoperative Urinary Retention in Older Women Undergoing Pelvic Organ Prolapse Surgery.
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接受盆腔器官脱垂手术的老年女性的虚弱和急性术后尿潴留。
DOI：
10.1097/spv.0000000000001289
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Ackenbom,MaryF
中科院分区：
文献类型：
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作者：
Zuo,StephanieW;Carter-Brooks,CharelleM;Zyczynski,HalinaM;Ackenbom,MaryF
目的本研究旨在探讨接受盆腔器官脱垂手术的老年妇女虚弱与POUR之间的关系。研究设计：这项对60岁及以上接受脱垂手术的女性进行的术后谵妄前瞻性研究的二级分析。术前使用Fried虚弱指数评估虚弱程度。急性POUR被定义为出院时未能通过逆行排尿试验，排尿后残留体积大于100毫升。结果分析纳入165名女性，平均±SD年龄为72.5±6.1岁，体重指数为28.0±4.4 kg/ m2。有49例腹腔镜/机器人根尖悬吊手术（29.7%），60例阴道闭塞手术（36.4%），47例阴道根尖悬吊手术（28.5%），9例孤立前/后阴道破裂（5.5%），其中9例合并尿失禁手术。78名妇女（47.3%）出现急性POUR。31例（18.8%）为“不虚弱”，115例（88.5%）为“虚弱”，19例（11.5%）为“虚弱”。虚弱状态和评分与POUR无关。在对Fried衰弱指数各个组成部分的分析中，自我报告的非故意体重减轻与POUR显著相关（优势比为4.6；95%可信区间为1.23-17.15）。这在多变量logistic回归中仍然是显著的（校正优势比为4.06；95%可信区间为1.01-16.39）。结论老年妇女脱垂手术中，身体虚弱与POUR无关。观察到的POUR与术前意外体重减轻之间的联系值得进一步调查。
ObjectiveThis study aimed to examine the association between frailty and POUR in older women who underwent pelvic organ prolapse surgery.Study DesignThis secondary analysis of a prospective study of postoperative delirium enrolled women 60 years and older undergoing prolapse surgery. The Fried Frailty Index was used to assess frailty before surgery. Acute POUR was defined as failure to pass a retrograde voiding trial at hospital discharge with postvoid residual volume of greater than 100 mL.ResultsAnalyses included 165 women, with a mean±SD age of 72.5±6.1 years and a body mass index of 28.0±4.4 kg/m 2. There were 49 laparoscopic/robotic apical suspension procedures (29.7%), 60 vaginal obliterative procedures (36.4%), 47 vaginal apical suspension procedures (28.5%), and 9 isolated anterior and/or posterior colporrhaphies (5.5%), of which 9 had a concomitant incontinence procedure. Seventy-eight women (47.3%) experienced acute POUR. Thirty-one (18.8%) met the criteria for “not frail,” 115 (88.5%) were “prefrail,” and 19 (11.5%) were “frail.” Neither frailty status nor score was associated with POUR. In an analysis of individual Fried Frailty Index components, self-reported unintentional weight loss was significantly associated with POUR (odds ratio, 4.6; 95% confidence interval, 1.23–17.15). This remained significant on multivariable logistic regression (adjusted odds ratio, 4.06; 95% confidence interval, 1.01–16.39).ConclusionsFrailty was not associated with POUR in older women undergoing prolapse surgery. The observed association between POUR and unintended weight loss before surgery warrants further investigation.