Life-space assessment in urogynecology and gynecological oncology surgery patients: a measure of perioperative mobility and function

Abstract

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.

Figures

Figure 1

Baseline and Postsurgical LSA Scores