The role of frailty on surgical outcomes following pelvic organ prolapse surgery in medicare beneficiaries: a national study
Open accessAbstract
Objective To evaluate the association of frailty with surgical outcomes following pelvic organ prolapse (POP) surgery in Medicare beneficiaries.Methods This is a retrospective cohort study of female Medicare beneficiaries ≥65 years of age undergoing POP surgery between 2014 and 2016. Primary outcomes were hospital length-of-stay (LOS) ≥3 days, 30-day post-operative complications (excluding urinary tract infections (UTI)), and 30-day UTI. Frailty was quantified using the validated Claims-Based Frailty Index (CFI) and categorized into not frail (CFI<0.15), pre-frail (0.15≤CFI<0.25), mildly frail (0.25≤CFI<0.35), and moderately to severely frail (0.35≤CFI≤1).Results Among the 107,890 women included (mean age, 73.3±6 years), 91.3% were White as and 4.3% were classified as mildly or moderately to severely frail. Rates of hospital LOS≥3 days and 30-day UTI increased over 7-fold and rates of 30-day complications increased over 3-fold as CFI increased from not frail to moderately to severely frail (all P values <.001). Compared to women who were not frail, women who were moderately to severely frail demonstrated an increased relative risk of hospital LOS≥3 days (aRR 3.1 [95% CI 2.5-3.8,P <.001]), 30-day complications (aRR 2.8 [95% CI 2.2-3.6, P <.001]), and 30-day UTI (aRR 2.5 [95% CI 2.2-3.0, P <.001]).Conclusion Among Medicare beneficiaries undergoing POP surgery in the United States, frailty is strongly associated with increased risk of prolonged hospital stay and 30-day complications. Frailty should be considered in the preoperative assessment for POP surgeries to improve patient outcomes.
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Many studies addressing perioperative outcomes and frailty, including in gynecologic surgery, are retrospective in nature or database driven.
“Many studies--including those looking at gynecologic surgery--addressing perioperative outcomes and frailty are retrospective in nature or database driven leaving opportunity for further understanding the impact of frailty on gynecologic surgery outcomes in prospective surgical trials.7–16”
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Cites
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
DEYO, R. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90133-8 · Cited by 10,452 · see citing works
Making Neighborhood-Disadvantage Metrics Accessible — The Neighborhood Atlas
Kind, A. J. H., & Buckingham, W. R. (2018) · New England Journal of Medicine · doi:10.1056/nejmp1802313 · Cited by 3,310 · see citing works
Leng, S. X., Chen, X., & Mao, G. (2014) · Clinical Interventions in Aging · doi:10.2147/cia.s45300 · Cited by 1,022 · see citing works
Forecasting the Prevalence of Pelvic Floor Disorders in U.S. Women
Wu, J. M., Hundley, A. F., Fulton, R. G., & Myers, E. R. (2009) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181c2ce96 · Cited by 767 · see citing works
Measuring Frailty in Medicare Data: Development and Validation of a Claims-Based Frailty Index
Kim, D. H., Schneeweiß, S., Glynn, R. J., Lipsitz, L. A., Rockwood, K. J., & Avorn, J. (2017) · The Journals of Gerontology Series A · doi:10.1093/gerona/glx229 · Cited by 628 · see citing works
Impact of frailty on outcomes in surgical patients: A systematic review and meta-analysis
Panayi, A. C., Orkaby, A. R., Sakthivel, D., Endo, Y., Varon, D. E., Roh, D. S., Orgill, D. P., Neppl, R. L., Javedan, H., Bhasin, S., et al. (2018) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2018.11.020 · Cited by 417 · see citing works
Kim, D. H., Glynn, R. J., Avorn, J., Lipsitz, L. A., Rockwood, K., Pawar, A., & Schneeweiss, S. (2019) · The Journals of Gerontology: Series A · doi:10.1093/gerona/gly197 · Cited by 285 · see citing works
Manku, K., Bacchetti, P., & Leung, J. M. (2003) · Anesthesia & Analgesia · doi:10.1213/00000539-200302000-00051 · Cited by 126 · see citing works
Manku, K., Bacchetti, P., & Leung, J. M. (2003) · Anesthesia & Analgesia · doi:10.1097/00000539-200302000-00051 · Cited by 115 · see citing works
Mora, J., Krepline, A. N., Aldakkak, M., Christians, K. K., George, B., Hall, W. A., Erickson, B. A., Kulkarni, N. M., Evans, D. B., & Tsai, S. (2020) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2020.12.001 · Cited by 79 · see citing works
Suskind, A. M., Jin, C., Walter, L. C., & Finlayson, E. V. A. (2016) · The Journal of Urology · doi:10.1016/j.juro.2016.12.001 · Cited by 56 · see citing works
Self-citationEffectiveness of Comanagement Model: Geriatric Medicine and Vascular Surgery
Natesan, S., Li, J. Y., Kyaw, K. K., Soh, Z. L. H., Yong, E., Hong, Q., Zhang, L., Chong, L. R. C., Tan, G. W. L., Chandrasekar, S., et al. (2021) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2021.10.022 · Cited by 29 · see citing works
Van Kuiken, M. E., Zhao, S., Covinsky, K., Boscardin, J., Finlayson, E., & Suskind, A. M. (2022) · Journal of Urology · doi:10.1097/ju.0000000000002441 · Cited by 19 · see citing works
Self-citationSuskind, A. M., Zhao, S., Boscardin, W. J., Covinsky, K. E., & Finlayson, E. V. A. (2020) · The Journal of Urology · doi:10.1097/ju.0000000000001331 · Cited by 11 · see citing works
Self-citationComparative outcomes for older adults undergoing surgery for bladder and bowel dysfunction
Suskind, A. M., Zhao, S., Nik‐Ahd, F., Boscardin, W. J., Covinsky, K. E., & Finlayson, E. V. A. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17118 · Cited by 3 · see citing works
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Flagged first, then by citations
Cited by
Sorted by citations
Gaber, C. E., Okpara, E., Abdelaziz, A., Sarker, J., Hanson, K. A., Hassan, L., Lin, F., Lee, T. A., & Reizine, N. M. (2025) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2024.102148 · Cited by 7 · see citing works
Nik‐Ahd, F., Zhao, S., Boscardin, W. J., Wang, L., Covinsky, K. E., & Suskind, A. M. (2024) · The Journal of Urology · doi:10.1097/ju.0000000000003978 · Cited by 6 · see citing works
Self-citationPelvic floor dysfunction in menopause: screening, evaluation and management
Misasi, G., Erkan, İ. B. Ö., Russo, E., Pisacreta, E., Fidecicchi, T., Guevara, M. M. M., & Simoncini, T. (2025) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2025.2604552 · Cited by 6 · see citing works
“Successful outcomes rely on thorough preoperative evaluation and a personalized surgical plan that takes comorbidities, physical, functional and cognitive status, and patient preferences – including sexual activity – into account [73,74].”
Managing pelvic floor dysfunction and incontinence in the frail older woman
Wagg, A. (2024) · Obstetrics Gynaecology & Reproductive Medicine · doi:10.1016/j.ogrm.2024.02.002 · Cited by 2 · see citing works
Nik‐Ahd, F., Zhao, S., Wang, L., Boscardin, W. J., Covinsky, K. E., & Suskind, A. M. (2024) · Neurourology and Urodynamics · doi:10.1002/nau.25573 · Cited by 1 · see citing works
Self-citationUroARC: A Novel Surgical Risk Calculator for Older Adults Undergoing Suprapubic Tube Placement
Nik‐Ahd, F., Zhao, S., Wang, L., Boscardin, W. J., Covinsky, K. E., & Suskind, A. M. (2024) · Urology · doi:10.1016/j.urology.2024.10.007 · Cited by 1 · see citing works
Self-citationErekson, E., Menefee, S. A., Whitworth, R., Gizlice, S., Zyczynski, H. M., Rahn, D. D., Amundsen, C. L., Sung, V. W., Arya, L. A., Ferrando, C. A., et al. (2026) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2025.11.002
Link, G., Meinhold-Heerlein, I. M., Zimmer, J., Favero, T. P., Schwandner, T., & Favero, G. (2024) · Obstetrics & Gynecology International Journal · doi:10.15406/ogij.2024.15.00775
D'Amico, M. J., Simhal, R. K., Bernardo, R. C., Wang, K. R., Capella, C. E., Shah, Y., Leong, J. Y., Shenot, P. J., Smith, W. R., & Murphy, A. M. (2025) · Urology · doi:10.1016/j.urology.2025.05.013
Health Care Disparities in Patients Undergoing Surgery for Pelvic Floor Disorders
Wieslander, C. K., Grimes, C. L., Balk, E. M., Gupta, A., Grisales, T., Singh, R., White, A. B., Hobson, D., Ringel, N. E., Orejuela, F. J., et al. (2025) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000006061
General Complications of Pelvic Reconstructive Surgery
Solomon, E. R., & Barber, M. D. (2025) · Springer eBooks · doi:10.1007/978-3-032-00339-3_4
- Authors
- Reddy, R., Zhao, S., Boscardin, W. J., Nik-Ahd, F., Van Kuiken, M., & Suskind, A. M.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- University of California, San Francisco (US)
- Corresponding author
- Reddy, Rishika
- Venue
- Urology
- Publisher
- Elsevier BV
- Published
- 2022-10
- Volume
- 168
- Pages
- 96-103
- ISSN
- 0090-4295 (ISSN-L)
- PMC
- PMC10999252
- OpenAlex
- W4285007171
- Cited by
- 12
- References
- 14
- Citations by year
- 2025: 7 · 2024: 5
- FWCI
- 1.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 381 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Urology (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG058616, T35AG026736)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Keywords
- frailty, pelvic organ prolapse surgery, claims-based frailty index, postoperative complications, urinary tract infection, length of hospital stay, Medicare beneficiaries, older women, preoperative assessment, surgical outcomes
- MeSH terms
- Frailty, Aged, Female, Medicare, Humans, Length of Stay, Postoperative Complications, Retrospective Studies, Risk Factors, United States, Treatment Outcome, Pelvic Organ Prolapse
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