Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Aesthet Surg J. 2021 Jun 14;41(7):NP796-NP803. doi: 10.1093/asj/sjab138.
Racial and socioeconomic disparities in access and quality of surgical care are well documented in many surgical subspecialties, including plastic surgery.
The authors aimed to determine if demographic disparities exist in preoperative and postoperative satisfaction after breast reduction mammaplasty, utilizing patient-reported quality of life (QoL) scores.
Patients who underwent breast reduction mammaplasty between 2015 and 2020 were identified. Patients who underwent complex concomitant procedures were excluded. Patient demographics and QoL, as measured by the BREAST-Q, were extracted. Wilcoxon Rank Sum and Kruskal-Wallis tests were employed to compare QoL scores across demographic subgroups.
A total of 115 patients met the inclusion criteria. QoL improved across all 4 BREAST-Q domains (all P < 0.001). Disparities were shown to exist in the following: median income vs postoperative satisfaction with information (P < 0.001), BMI vs preoperative physical well-being (P < 0.001), and ethnicity vs preoperative physical well-being (P = 0.003). A sub-group analysis of Caucasian patients compared with Black/African American patients revealed significant inequalities in BMI (P < 0.001), median income by zip code (P < 0.001), improvement in satisfaction with breasts (P = 0.039), satisfaction with information (P = 0.007), and satisfaction with office staff (P = 0.044).
Racial and socioeconomic inequalities exist in preoperative and postoperative satisfaction for patients undergoing breast reduction mammaplasty. Institutions should focus on developing tools for equitable and inclusive patient education and perioperative counseling.
在许多外科专业领域，包括整形外科学，种族和社会经济差异在手术护理的可及性和质量方面都有详细记录。
作者旨在利用患者报告的生活质量 (QoL) 评分，确定在接受乳房缩小成形术前后，患者的术前和术后满意度是否存在人口统计学差异。
确定了 2015 年至 2020 年间接受乳房缩小成形术的患者。排除了同时进行复杂手术的患者。提取了患者的人口统计学数据和 QoL 数据，通过 BREAST-Q 进行评估。采用 Wilcoxon 秩和检验和 Kruskal-Wallis 检验比较了各人口统计学亚组的 QoL 评分。
共有 115 名患者符合纳入标准。所有 4 个 BREAST-Q 领域的 QoL 均有所改善（均 P<0.001）。存在以下差异：收入中位数与术后信息满意度（P<0.001）、BMI 与术前生理健康（P<0.001）以及种族与术前生理健康（P=0.003）。对白人患者与黑人/非裔美国人患者的亚组分析显示，BMI（P<0.001）、邮政编码中位数收入（P<0.001）、乳房满意度改善（P=0.039）、信息满意度（P=0.007）和对办公室工作人员的满意度（P=0.044）存在显著差异。
接受乳房缩小成形术的患者存在术前和术后满意度的种族和社会经济不平等。各机构应重点开发公平和包容的患者教育和围手术期咨询工具。
