Risk Factors for Cardiopulmonary Complications in Surgeries for Benign Ovarian Tumors

Background: In recent years, advances in medical care have improved surgical outcomes in elderly patients with comorbidities, particularly in elective surgeries for non-malignant conditions. Assessing risk factors is crucial for enhancing safety in older patients undergoing surgery for benign ovarian cysts (BOC), given the increased potential for postoperative complications. This study aimed to identify key predictors of postoperative non-surgical complications in patients over 65 and to assess the incidence of these predictors, focusing on cardiorespiratory events. Methods and Results: This retrospective study included 288 female patients aged ≥65 and under 65 who underwent elective surgery for benign ovarian cyst removal at a single clinical center. The primary outcome was the incidence of cardiorespiratory complications (CRC), with predictive factors such as obesity, hypertension, and age analyzed through univariate and multivariate models. The study utilized a Random Forest model to assess the predictive value of these risk factors and compared the predicted risk with observed complication rates to evaluate model accuracy. Calibration and complication odds ratios were computed to establish the significance of predictive variables. Among the studied patients, obesity and hypertension emerged as significant independent predictors of postoperative CRC, while age alone did not contribute significantly to risk. CRC, including pneumonia, respiratory failure, arrhythmias, and hypertensive crises, were recorded in 8.7% of patients. The Random Forest model confirmed obesity and hypertension had a greater influence than age as determinants of complication risk, suggesting that comorbid conditions substantially increase postoperative risks. Conclusion: This study highlights the importance of comorbidities, particularly obesity and hypertension, as primary predictors of postoperative complications in elderly patients undergoing surgery for BOC. Age alone was not a significant risk factor, indicating that tailored management of comorbid conditions may better mitigate postoperative risks than focusing on age as an isolated factor.