METHODS: We conducted a historical cohort study using the French nationwide claim database (PMSI) from January 2013 to December 2021. All women who sustained an OASI repair following a vaginal delivery were included and virtually followed-up for 2 years. Then, we searched for OASIS complications. Finally, we evaluated factors associated with OASIS complication repaired or not and OASIS complication repairs.
RESULTS: Among the 61,833 included women, 2015 (2.8%) had an OASI complication and 842 (1.16%) underwent an OASI complication repair. Women were mainly primiparous (71.6%) and 44.3% underwent an instrumental delivery. During a follow-up of 2 years, 0.6% (n = 463), 0.3% (n = 240), 0.2% (n = 176), 0.1% (n = 84), 0.06% (n = 43) and 0.01% (n = 5) of patients underwent second surgery for a perineal repair, a fistula repair, a sphincteroplasty, a perineal infection, a colostomy and a sacral nervous anal stimulation, respectively. Only one case of artificial anal sphincter was noticed. Instrumental deliveries (OR = 1.56 CI95%[1.29;1.9]), private for-profit hospitals (OR = 1.42 [1.11;1.82], reference group \"public hospital\"), obesity (OR = 1.36 [1;1.84]), stage IV OASIS (OR = 2.98 [2.4;3.72]), perineal wound breakdown (OR = 2.8 [1.4;5.48]), ages between 25 and 29 years old (OR = 1.59 [1.17;2.18], refence group \"age between 13 and 24 years old\") and 30 and 34 years old (OR = 1.57 [1.14; 2.16], refence group \"age between 13 and 24 years old\") were factors associated with OASIS complication repairs.
CONCLUSIONS: Maternal age, stage IV OASIS, obesity, instrumental deliveries and private for-profit hospitals seemed to predict OASIS complications. Understanding factors associated with OASIS complications could be beneficial for the patient to inform them and to influence the patient\'s follow-up in order to prevent complications, repairs and maternal distress.
方法:我们从2013年1月至2021年12月使用法国全国索赔数据库(PMSI)进行了一项历史队列研究。包括所有在阴道分娩后进行OASI修复的妇女,并进行了2年的随访。然后,我们搜索了OASIS并发症.最后,我们评估了OASIS并发症修复与否和OASIS并发症修复的相关因素.
结果:在61,833名女性中,2015年(2.8%)发生OASI并发症,842例(1.16%)接受了OASI并发症修复。妇女主要是初产(71.6%),而44.3%的妇女接受了器械分娩。在2年的随访中,0.6%(n=463),0.3%(n=240),0.2%(n=176),0.1%(n=84),0.06%(n=43)和0.01%(n=5)的患者接受了会阴修复的第二次手术,瘘管修复术,括约肌成形术,会阴感染,结肠造口术和骶神经肛门刺激,分别。仅发现一例人工肛门括约肌。工具交付(OR=1.56CI95%[1.29;1.9]),私营营利性医院(OR=1.42[1.11;1.82],参考组“公立医院”),肥胖(OR=1.36[1;1.84]),第四阶段绿洲(OR=2.98[2.4;3.72]),会阴伤口破裂(OR=2.8[1.4;5.48]),年龄在25至29岁之间(OR=1.59[1.17;2.18],复习组“年龄在13至24岁之间”)和30至34岁(OR=1.57[1.14;2.16],复习组“年龄在13至24岁之间”)是与OASIS并发症修复相关的因素。
结论:产妇年龄,第四阶段绿洲,肥胖,工具性分娩和私立营利性医院似乎可以预测OASIS并发症。了解与OASIS并发症相关的因素可能有利于患者告知这些因素,并影响患者的随访,以预防并发症。修复和产妇痛苦。