Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
J Plast Reconstr Aesthet Surg. 2024 Jan;88:493-499. doi: 10.1016/j.bjps.2023.11.034. Epub 2023 Nov 24.
Given that patients with morbid obesity are predisposed to frailty, we sought to determine whether the 5-Factor Modified Frailty Index (mFI-5) predicts postoperative complications following surgery for adult-acquired buried penis, and secondarily, to compare the mFI-5 to body mass index (BMI) and American Society of Anesthesiologists (ASA) status as preoperative risk stratification measures.
We included all patients who underwent surgical management for adult-acquired buried penis at an academic Level I trauma center between 2015 and 2023. A manual chart review was performed to collect data on patient demographics, modified frailty index variables, intraoperative data, postoperative outcomes, and complications.
A total of 55 patients underwent surgical repair of adult-acquired buried penis, with 26 experiencing postoperative complications (47.3%). Univariable regression analyses revealed that the mFI-5 was a significant predictor of postoperative complications (odds ratio [OR] 3.40, 95% confidence interval [CI]: 1.56-7.42, p = .002), ongoing postoperative urinary problems (OR 2.03, 95% CI: 1.02-4.05, p = .045), patient dissatisfaction with outcomes (OR 3.29, 95% CI: 1.35-8.02, p = .009), and persistent postoperative symptoms (OR 2.42, 95% CI: 1.10-5.35, p = .029). There was no significant association between ASA classification and postoperative complications (OR 1.59, 95% CI:.544-4.63, p = .398). Multivariable analysis demonstrated that the mFI-5 was an independent predictor of postoperative complications (OR 5.34, 95% CI: 1.80-15.9, p = .003) when controlling for BMI and age.
The mFI-5 is an independent predictor of postoperative complications in patients undergoing surgical repair of adult-acquired buried penis. The simplicity of the index permits efficient preoperative risk stratification of adult-acquired buried penis patients and provides important counseling information that may not be reflected by age or BMI alone.
鉴于病态肥胖患者易发生衰弱，我们旨在确定 5 项修正衰弱指数（mFI-5）是否可预测成人获得性埋藏性阴茎手术后的并发症，其次，比较 mFI-5 与身体质量指数（BMI）和美国麻醉医师协会（ASA）状态作为术前风险分层措施。
我们纳入了 2015 年至 2023 年在学术一级创伤中心接受手术治疗的所有成人获得性埋藏性阴茎患者。进行手动图表审查以收集患者人口统计学资料、修正衰弱指数变量、术中数据、术后结果和并发症的数据。
共有 55 例患者接受了成人获得性埋藏性阴茎的手术修复，其中 26 例（47.3%）发生了术后并发症。单变量回归分析显示，mFI-5 是术后并发症（优势比[OR]3.40，95%置信区间[CI]：1.56-7.42，p=.002）、持续术后尿问题（OR 2.03，95%CI：1.02-4.05，p=.045）、患者对结果不满意（OR 3.29，95%CI：1.35-8.02，p=.009）和持续术后症状（OR 2.42，95%CI：1.10-5.35，p=.029）的显著预测因子。ASA 分类与术后并发症之间无显著关联（OR 1.59，95%CI：.544-4.63，p=.398）。多变量分析表明，在控制 BMI 和年龄后，mFI-5 是术后并发症的独立预测因子（OR 5.34，95%CI：1.80-15.9，p=.003）。
mFI-5 是接受成人获得性埋藏性阴茎手术修复患者术后并发症的独立预测因子。该指数的简单性允许对成人获得性埋藏性阴茎患者进行有效的术前风险分层，并提供重要的咨询信息，这些信息可能无法单独通过年龄或 BMI 反映。
