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年龄因素对减肥后身体塑形手术效果的影响。

The Age Factor in Postbariatric Body Contouring Surgery Outcome.

机构信息

From the Department of Plastic and Reconstructive Surgery and Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University.

出版信息

Plast Reconstr Surg. 2022 Mar 1;149(3):417e-423e. doi: 10.1097/PRS.0000000000008817.

Abstract

BACKGROUND

Increasing life expectancy will likely lead greater numbers of older patients to seek postbariatric body contouring plastic surgery. The impact of age on body contouring plastic surgery outcome is undetermined.

METHODS

A retrospective cohort study of 317 postbariatric body contouring plastic surgery cases was performed. Patient demographics and operative and postoperative data were collected. Patients were categorized into three age groups, and univariate analysis examined group differences. Multivariate logistic regression analysis assessed independent associations between age and surgical outcome measures.

RESULTS

Patients 60 years and older had a higher mean preoperative body mass index (30.8 ± 3.6 kg/m2, p < 0.001) and higher rates of hypertension (48.9 percent, p < 0.001), dyslipidemia (38.3 percent, p < 0.001), and diabetes mellitus (17 percent, p = 0.012) compared to the younger age groups. They also sustained significantly higher complication rates (any minor complications, p = 0.004; minor surgical site infections, p = 0.005; minor hematomas, p = 0.007; any major complications, p < 0.001; major surgical-site infections, p < 0.001; and major dehiscence, p < 0.001). Increasing age was a significant risk factor for any major complications (p = 0.005), reoperation (p = 0.02), and readmission (p = 0.001). Age greater than or equal to 60 years was a significant risk factor solely for readmission (OR, 3.32; p = 0.03).

CONCLUSIONS

Increasing age was a risk factor for adverse postoperative outcome in postbariatric body contouring plastic surgery patients; however, age greater than or equal to 60 years in and of itself was an independent risk factor for readmission only. These findings may aid plastic surgeons in patient consultation and in decision making regarding suitable candidates for these procedures.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.

摘要

背景

预期寿命的延长可能会导致更多的老年患者寻求减重后身体整形手术。年龄对身体整形手术结果的影响尚不确定。

方法

对 317 例减重后身体整形手术的回顾性队列研究。收集患者人口统计学和手术及术后数据。将患者分为三组,并进行单因素分析以检查组间差异。多变量逻辑回归分析评估了年龄与手术结果测量之间的独立关联。

结果

60 岁及以上的患者术前平均体重指数(30.8±3.6kg/m2,p<0.001)更高,高血压(48.9%,p<0.001)、血脂异常(38.3%,p<0.001)和糖尿病(17%,p=0.012)的发生率更高,与年轻组相比。他们还出现了显著更高的并发症发生率(任何轻微并发症,p=0.004;轻微手术部位感染,p=0.005;轻微血肿,p=0.007;任何主要并发症,p<0.001;主要手术部位感染,p<0.001;和主要裂开,p<0.001)。年龄增长是任何重大并发症(p=0.005)、再次手术(p=0.02)和再次入院(p=0.001)的显著危险因素。年龄大于或等于 60 岁是再次入院的唯一显著危险因素(OR,3.32;p=0.03)。

结论

年龄增长是减重后身体整形手术患者术后不良结果的危险因素;然而,年龄大于或等于 60 岁本身仅是再次入院的独立危险因素。这些发现可能有助于整形外科医生对患者进行咨询,并在决定适合这些手术的合适人选时提供参考。

临床问题/证据水平:风险,II 级。

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