The risk of perioperative cardiovascular complications following urinary incontinence and pelvic organ prolapse (POP) operations must be taken into consideration during surgical planning. The literature on the cardiovascular risk following urinary incontinence and pelvic organ prolapse operations shows conflicting results. Our aims were to provide an estimate of the mortality and the risk of cardiovascular complications following urinary incontinence and pelvic organ prolapse operations considering the women's preoperative cardiovascular comorbidity.
This nationwide register-based study includes a total of 13 992 urinary incontinence and 35 765 pelvic organ prolapse operations from 2007 through 2017. The risk was estimated as an incidence rate ratio for women with and without former cardiovascular comorbidity adjusted for relevant confounders by using a case-crossover study design.
A total of 7 677 patients were at high risk with a cardiovascular comorbidity prior to the operation and 42 076 patients were at low risk with no cardiovascular comorbidity. Overall, eleven patients died within 30 days following an operation, five patients died in the high-risk group and six in the low-risk group. Of the high-risk women, 0.59% had cardiovascular complications during 0-6 day following an operation, corresponding to an incidence rate ratio of 3.64 (95% CI; 2.67 to 4.97) compared to the low-risk women where no complications were registered the first week.
We found an increased risk of cardiovascular complications following urogynecological operations in women with preoperative cardiovascular comorbidity, and no increased risk in women without prior cardiovascular comorbidity. In general, the risk of cardiovascular complications was lower than in previous studies. This article is protected by copyright. All rights reserved.
Acta obstetricia et gynecologica Scandinavica. 2018 Sep 06 [Epub ahead of print]
Michael Due Larsen, Rikke Guldberg, Gunnar Lose
Center for Clinical Epidemiology, Odense University Hospital and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark., Department of Obstetrics and Gyaecology, Aarhus University Hospital, Aarhus, Denmark., Gynecology and Obstetrics Department, Herlev Hospital and University of Copenhagen, Copenhagen, Denmark.