Bibliographic Details
| Title: |
Risk Factors for Adhesion-Related Readmission and Abdominal Reoperation after Gynecological Surgery: A Nationwide Cohort Study. |
| Authors: |
Toneman, Masja, Groenveld, Tjitske, Krielen, Pepijn, Hooker, Angelo, de Wilde, Rudy, Torres-de la Roche, Luz Angela, Di Spiezio Sardo, Atillio, Koninckx, Philippe, Cheong, Ying, Nap, Annemiek, van Goor, Harry, Pargmae, Pille, ten Broek, Richard |
| Source: |
Journal of Clinical Medicine; Feb2023, Vol. 12 Issue 4, p1351, 12p |
| Subject Terms: |
GYNECOLOGIC surgery, REOPERATION, PATIENT readmissions, TRANSVAGINAL surgery, INFLAMMATORY bowel diseases, PELVIC examination |
| Abstract: |
More than half of women in developed countries undergo surgery during their lifetime, putting them at risk of adhesion-related complications. Adhesion-related complications include small bowel obstruction, chronic (pelvic) pain, subfertility, and complications associated with adhesiolysis during reoperation. The aim of this study is to predict the risk for adhesion-related readmission and reoperation after gynecological surgery. A Scottish nationwide retrospective cohort study was conducted including all women undergoing a gynecological procedure as their initial abdominal or pelvic operation between 1 June 2009 and 30 June 2011, with a five-year follow-up. Prediction models for two- and five-year risk of adhesion-related readmission and reoperation were constructed and visualized using nomograms. To evaluate the reliability of the created prediction model, internal cross-validation was performed using bootstrap methods. During the study period, 18,452 women were operated on, and 2719 (14.7%) of them were readmitted for reasons possibly related to adhesions. A total of 2679 (14.5%) women underwent reoperation. Risk factors for adhesion-related readmission were younger age, malignancy as indication, intra-abdominal infection, previous radiotherapy, application of a mesh, and concomitant inflammatory bowel disease. Transvaginal surgery was associated with a lower risk of adhesion-related complications as compared to laparoscopic or open surgeries. The prediction model for both readmissions and reoperations had moderate predictive reliability (c-statistics 0.711 and 0.651). This study identified risk factors for adhesion-related morbidity. The constructed prediction models can guide the targeted use of adhesion prevention methods and preoperative patient information in decision-making. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
