Liu Helen, Akhavan Arya, Yin Raymond, Ibelli Taylor, Mandelbaum Max, Katz Abigail, Etigunta Suhas, Alerte Eric, Kuruvilla Annet, Liu Chuanju, Taub Peter J
Aesthet Surg J Open Forum. 2023 Jul 18;5:ojad067. doi: 10.1093/asjof/ojad067. eCollection 2023.
The ability to predict breast implant augmentation complications can significantly inform patient management. A frailty measure, such as the modified 5-item frailty index (mFI-5), is becoming an increasingly established risk factor for adverse postoperative outcomes. The authors hypothesized that the mFI-5 is predictive of 30-day postoperative complications in breast augmentation.
To investigate if mFI-5 can predict the likelihood and magnitude of 30-day complications resulting from breast augmentations.
A retrospective review study of the National Surgical Quality Improvement Program database for patients who underwent breast implant augmentation without other concurrent procedures, from 2015 to 2019. Age, BMI, number of major comorbidities, American Society of Anesthesiologists (ASA) classifications, smoking status, mFI-5 score, and modified Charlson comorbidity index score were compared as predictors of all-cause 30-day complications and 30-day surgical-site complications using regression analyses.
Overall, 2478 patients were analyzed, and among them, 53 patients developed complications (2.14%). mFI-5 score significantly predicted surgical-site infection (SSI) complications (odds ratio [OR] = 4.24, = .026). Frail patients had a higher occurrence of SSIs than nonfrail patients ( = .049). Multivariable analyses showed ASA class predicted 30-day SSI complications (OR = 5.77, = .027) and mFI-5 approached, but did not reach full significance in predicting overall 30-day complications (OR = 3.14, = .085).
To date, the impact of frailty on breast implant procedure outcomes has not been studied. Our analysis demonstrates that the mFI-5 is a significant predictor for SSIs in breast implant augmentation surgery and is associated with overall complications. By preoperatively identifying frail patients, the surgical team can better account for postoperative support to minimize the risk of complications.
预测隆胸手术并发症的能力可为患者管理提供重要信息。一种衰弱指标，如改良的5项衰弱指数（mFI-5），正日益成为术后不良结局的危险因素。作者假设mFI-5可预测隆胸术后30天的并发症。
研究mFI-5能否预测隆胸术后30天并发症的可能性及严重程度。
对2015年至2019年美国国家外科质量改进计划数据库中接受隆胸手术且无其他同期手术的患者进行回顾性研究。比较年龄、体重指数、主要合并症数量、美国麻醉医师协会（ASA）分级、吸烟状况、mFI-5评分和改良查尔森合并症指数评分，通过回归分析作为全因30天并发症和30天手术部位并发症的预测因素。
总体上，分析了2478例患者，其中53例出现并发症（2.14%）。mFI-5评分显著预测手术部位感染（SSI）并发症（比值比[OR]=4.24，P=.026）。衰弱患者的SSI发生率高于非衰弱患者（P=.049）。多变量分析显示ASA分级预测30天SSI并发症（OR=5.77，P=.027），mFI-5接近但未达到预测总体30天并发症的完全显著性（OR=3.14，P=.085）。
迄今为止，衰弱对隆胸手术结局的影响尚未得到研究。我们的分析表明，mFI-5是隆胸手术中SSI的重要预测指标，且与总体并发症相关。通过术前识别衰弱患者，手术团队可以更好地考虑术后支持，以尽量降低并发症风险。
