POSTOPERATIVE COMPLICATIONS IN FEMALE NEUROSURGICAL PATIENTS, INCLUDING GYNAECOLOGICAL COMORBIDITIES, AT A TEACHING HOSPITAL IN PAKISTAN

Background: Postoperative complications are a major concern in neurosurgical practice, particularly among female patients, where underlying hormonal and anatomical factors may further influence surgical recovery. Gynecological comorbidities such as polycystic ovarian syndrome (PCOS), uterine fibroids, endometriosis, and menstrual irregularities are common in women of reproductive age and may alter immune responses, coagulation profiles, and fluid balance. However, the impact of these conditions on neurosurgical outcomes remains under-investigated, especially in low-resource settings. Objective: To evaluate the incidence and types of postoperative complications in female neurosurgical patients and to determine the influence of coexisting gynecological comorbidities on these outcomes in a tertiary care hospital in Pakistan. Methods: A descriptive observational study was conducted at the Department of Neurosurgery, Hayatabad Medical Complex, Peshawar, from January 2024 to March 2025. Female patients undergoing neurosurgical procedures were included, while male patients, minor outpatient cases, and incomplete records were excluded. Data on demographics, surgical type, gynecological comorbidities, and complications within 30 days post-surgery were collected. Complications were categorized as surgical or systemic. Statistical analysis was performed using SPSS v26; chi-square and logistic regression analyses were applied with significance set at p < 0.05. Results: Of 364 female patients, 112 (30.77%) had gynecological comorbidities. PCOS was the most common (34.82%), followed by menstrual irregularities (25.00%), uterine fibroids (23.21%), and endometriosis (16.96%). Postoperative complications were reported in 138 (37.91%) patients. Those with gynecological comorbidities had significantly higher rates of complications (54.46% vs. 30.56%, p < 0.001), including wound infections (16.96% vs. 9.13%, p = 0.047), thromboembolic events (12.50% vs. 5.56%, p = 0.018), electrolyte imbalances (17.86% vs. 9.92%, p = 0.042), and prolonged hospital stays (34.82% vs. 19.05%, p = 0.003). Conclusion: Gynecological comorbidities independently contribute to a higher risk of postoperative complications in female neurosurgical patients, underscoring the need for integrated perioperative strategies.