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Life‐Space Assessment in Urogynecology and Gynecological Oncology Surgery Patients: A Measure of Perioperative Mobility and Function
Author(s) -
Stewart Chere M. L.,
Wheeler Thomas L.,
Markland Alayne D.,
Straughn J. Michael,
Richter Holly E.
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2009.02557.x
Subject(s) - urogynecology , medicine , prospective cohort study , perioperative , confidence interval , gynecological surgery , surgery , urinary incontinence
OBJECTIVE: To assess the effect of gynecological surgery on mobility and functional status in women aged 60 and older using Life‐Space Assessment (LSA). DESIGN: Observational prospective cohort study. SETTING: Academic outpatient urogynecology and gynecological oncology clinics. PARTICIPANTS: Women presenting for urogynecology (n=51) and gynecological oncology (n=51) surgery. MEASUREMENTS: LSA scores 6 weeks, 6 months, and 1 year after surgery. Information on participant demographics, preoperative diagnoses, surgical approach, and medical comorbidities was collected. Analyses used repeated measures. RESULTS: Mean age was 71 ± 7. Urogynecology participants started and maintained a higher LSA ( P =.03) than oncology participants at all study intervals. Six weeks after surgery, urogynecology and oncology participants' mean decline was 13 points (95% confidence interval (CI)=4–21; P =.004) and 23 points (95% CI=13–33; P <.001), respectively. At 6 months, the urogynecology and oncology participants' scores increased by a mean of 9 points (95% CI=1–17; P =.03) and 13 points (95% CI=5–20; P =.001), respectively. No significant difference was found 1 year from baseline within each group or between groups in LSA scores. Income, depression, body mass index, and having an operative complication predicted a larger decline in life‐space over time in both groups. CONCLUSION: Gynecological surgical interventions in older women limit physical and functional ability at 6 weeks after surgery. The urogynecology and gynecological oncology cohorts returned to baseline levels by 6 months, which was sustained to 1 year.