From the Division of Plastic, Oral, and Maxillofacial Surgery, Duke University.
Calc LLC.
Plast Reconstr Surg. 2023 Jun 1;151(6):1169-1178. doi: 10.1097/PRS.0000000000010148. Epub 2023 Jan 2.
Tracking surgical complications and unplanned healthcare utilization is essential to inform quality initiatives in aesthetic surgery. This study used the Tracking Operations and Outcomes for Plastic Surgeons database to characterize rates and predictors of surgical complications and unplanned healthcare utilization across common aesthetic surgery procedures.
The Tracking Operations and Outcomes for Plastic Surgeons database was queried for all patients undergoing breast augmentation, liposuction, blepharoplasty, rhinoplasty, and abdominoplasty from 2008 to 2019. Incidence and risk factors for complications and unplanned readmission, reoperation, and emergency room visits were determined.
A total of 214,504 patients were identified. Overall, 94,618 breast augmentations, 56,756 liposuction procedures, 29,797 blepharoplasties, 24,946 abdominoplasties, and 8387 rhinoplasties were included. A low incidence of perioperative complications was found, including seroma (1.1%), hematoma (0.7%), superficial wound complication (0.9%), deep surgical-site infection (0.2%), need for blood transfusion (0.05%), and deep venous thrombosis/pulmonary embolism (0.1%). Incidence of unplanned readmission, emergency room visits, and reoperation were 0.34%, 0.25%, and 0.80%, respectively. Patients who underwent an abdominoplasty more commonly presented to the emergency room and had unplanned readmissions or reoperations compared with other studied procedures. Furthermore, increased age, diabetes, higher body mass index, American Society of Anesthesiologists class, longer operative times, and pursuit of combined aesthetic procedures were associated with increased risk for unplanned health care use.
There is a low incidence of perioperative complications and unplanned healthcare utilization following common aesthetic surgery procedures. Continued entry into large national databases in aesthetic surgery is essential for internal benchmarking and quality improvement.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
追踪手术并发症和非计划性医疗保健利用对于告知美容手术中的质量计划至关重要。本研究使用整形医生手术操作和结果追踪数据库（Tracking Operations and Outcomes for Plastic Surgeons database），对常见美容手术程序的手术并发症和非计划性医疗保健利用的发生率和预测因素进行了特征描述。
对 2008 年至 2019 年期间接受隆胸术、吸脂术、眼睑成形术、鼻成形术和腹部整形术的所有患者进行了整形医生手术操作和结果追踪数据库查询。确定了并发症和非计划性再入院、再次手术和急诊就诊的发生率和危险因素。
共确定了 214504 名患者。总共包括 94618 例隆胸术、56756 例吸脂术、29797 例眼睑成形术、24946 例腹部整形术和 8387 例鼻成形术。发现围手术期并发症的发生率较低，包括血清肿（1.1%）、血肿（0.7%）、浅表伤口并发症（0.9%）、深部手术部位感染（0.2%）、需要输血（0.05%）和深静脉血栓形成/肺栓塞（0.1%）。非计划性再入院、急诊就诊和再次手术的发生率分别为 0.34%、0.25%和 0.80%。与其他研究程序相比，接受腹部整形术的患者更常到急诊就诊，并且有非计划性再入院或再次手术。此外，年龄较大、糖尿病、较高的身体质量指数、美国麻醉医师协会分类、较长的手术时间以及追求联合美容手术与非计划性医疗保健利用的风险增加相关。
常见美容手术程序后围手术期并发症和非计划性医疗保健利用的发生率较低。继续在美容手术中输入大型国家数据库对于内部基准测试和质量改进至关重要。
临床问题/证据水平：风险，III 级。
