Adabi Kian, Stern Carrie S, Weichman Katie E, Garfein Evan S, Pothula Aravind, Draper Lawrence, Tepper Oren M
Bronx, N.Y.
From the Montefiore Medical Center, Albert Einstein College of Medicine.
Plast Reconstr Surg. 2017 Jul;140(1):66-74. doi: 10.1097/PRS.0000000000003459.
Fifteen million U.S. patients each year seek medical care abroad; however, there are no data on outcomes and follow-up of these procedures. This study aims to identify, evaluate, and survey patients presenting with complications from aesthetic procedures abroad and estimate their cost to the U.S. health care system.
A single-center retrospective review was conducted. A cohort of patients presenting with complications from aesthetic procedures performed abroad was generated. Demographic, complication, and cost data were compiled. Patients were surveyed to assess their overall experience.
Over a 36-month period, 42 patients met inclusion criteria (one man and 41 women), with an average age of 35 ± 11.4 years (range, 20 to 60 years). Comorbidities included four active smokers, two patients with hypertension, and one patient with diabetes. Average body mass index was 29 ± 4.4 kg/m (range, 22 to 38 kg/m). Procedures performed abroad included abdominoplasty (n = 28), liposuction (n = 20), buttock augmentation (n = 10), and breast augmentation (n = 7), with several patients undergoing combined procedures. Eleven patients presented with abscesses and eight presented with wound dehiscence. Eight of the 18 patients who were surveyed were not pleased with their results and 11 would not go abroad again for subsequent procedures. Average cost of treating the complications was $18,211, with an estimated cost to the U.S. health care system of $1.33 billion. The main payer group was Medicaid.
Complications from patients seeking aesthetic procedures abroad will continues to increase. Patients should be encouraged to undergo cosmetic surgery in the United States to improve patient outcomes and satisfaction and because it is economically advantageous.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
每年有1500万美国患者到国外寻求医疗服务；然而，目前尚无关于这些手术的结果和后续随访的数据。本研究旨在识别、评估和调查那些在国外接受美容手术后出现并发症的患者，并估算这些并发症给美国医疗系统带来的成本。
进行了一项单中心回顾性研究。纳入了一组在国外接受美容手术后出现并发症的患者。收集了人口统计学、并发症和成本数据。对患者进行了调查，以评估他们的总体体验。
在36个月的时间里，42名患者符合纳入标准（1名男性和41名女性），平均年龄为35±11.4岁（范围为20至60岁）。合并症包括4名现吸烟者、2名高血压患者和1名糖尿病患者。平均体重指数为29±4.4kg/m²（范围为22至38kg/m²）。在国外进行的手术包括腹壁成形术（n = 28）、吸脂术（n = 20）、臀部增大术（n = 10）和隆胸术（n = 7），有几名患者接受了联合手术。11名患者出现脓肿，8名患者出现伤口裂开。在接受调查的18名患者中，有8名对结果不满意，11名表示不会再到国外进行后续手术。治疗并发症的平均费用为18,211美元，给美国医疗系统造成的估计成本为13.3亿美元。主要支付方是医疗补助计划。
到国外寻求美容手术的患者并发症将会持续增加。应鼓励患者在美国进行整容手术，以改善患者的手术效果和满意度，并且从经济角度来看也是有利的。
临床问题/证据级别：治疗性，四级。
