From the Department of Plastic, Reconstructive, and Aesthetic Surgery.
Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU Limoges.
Plast Reconstr Surg. 2024 May 1;153(5):1011-1019. doi: 10.1097/PRS.0000000000010828. Epub 2023 Jun 19.
Breast reduction surgery for hypertrophy is one of the most commonly performed procedures in plastic surgery. This surgery exposes patients to complications that are well-documented in the literature. The objective of this study is to identify risk factors to establish an estimate of the risk of developing complications. The authors propose the first predictive score of postoperative complications, including continuous preoperative variables such as body mass index (BMI) and suprasternal notch-to-nipple distance (SSN:N).
An analytic observational retrospective cohort study was conducted including 1306 patients who underwent superior pedicle reduction mammaplasty at the Rennes University Hospital (France) between January 1, 2011, and December 31, 2016. The primary endpoint was to study the association between known preoperative risk factors and occurrence of any complications using multivariable logistic regression to identify independent risk factors. A secondary endpoint was to establish a score to estimate a probability of occurrence of complications.
A total of 1306 patients were analyzed. Multivariable logistic regression showed three independent risk factors: active smoking [OR, 6.10 (95% CI: 4.23, 8.78); P < 0.0001], BMI [OR, 1.16 (95% CI: 1.11, 1.22); P < 0.0001], and SSN:N [OR, 1.14 (95% CI: 1.08, 1.21); P < 0.0001]. The Rennes Plastic Surgery Score estimating the occurrence of postoperative complications was determined, integrating regression coefficients of each risk factor.
Active smoking, BMI, and SSN:N distance are independent preoperative risk factors for the occurrence of breast reduction complications. The Rennes Plastic Surgery Score including the continuous values of BMI and SSN:N allows us to provide our patients with a reliable estimation of the risk of occurrence of these complications.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
巨乳缩小术是整形外科学中最常施行的手术之一。该手术使患者面临诸多文献中已有记载的并发症。本研究旨在确定风险因素，以评估并发症发生的风险。作者提出了首个术后并发症预测评分，其中包含 BMI 和胸骨上切迹至乳头距离（SSN:N）等连续术前变量。
对雷恩大学医院（法国）2011 年 1 月 1 日至 2016 年 12 月 31 日期间行上蒂乳缩小术的 1306 例患者进行了分析性观察性回顾性队列研究。主要终点是使用多变量逻辑回归研究已知术前危险因素与任何并发症发生之间的关系，以确定独立危险因素。次要终点是建立评分以估计并发症发生的概率。
共分析了 1306 例患者。多变量逻辑回归显示 3 个独立危险因素：吸烟[比值比（OR），6.10（95%置信区间：4.23，8.78）；P＜0.0001]、BMI（OR，1.16（95%置信区间：1.11，1.22）；P＜0.0001）和 SSN:N（OR，1.14（95%置信区间：1.08，1.21）；P＜0.0001）。确定了估计术后并发症发生的雷恩整形外科评分，整合了每个危险因素的回归系数。
吸烟、BMI 和 SSN:N 距离是乳缩小术并发症发生的独立术前危险因素。包括 BMI 和 SSN:N 连续值的雷恩整形外科评分可使我们为患者提供发生这些并发症风险的可靠估计。
临床问题/证据水平：风险，III 级。
