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代谢综合征对腹部身体塑形术后结局的影响:全国倾向评分匹配分析。

The Impact of Metabolic Syndrome on Postoperative Outcomes in Abdominal Body Contouring: A Propensity Score-Matched Nationwide Analysis.

机构信息

Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Boston, MA, 02215, USA.

Division of Plastic and Reconstructive Surgery, Universidad El Bosque, Bogota, Colombia.

出版信息

Aesthetic Plast Surg. 2024 Oct;48(20):4168-4177. doi: 10.1007/s00266-024-04227-3. Epub 2024 Jul 16.

Abstract

BACKGROUND

Metabolic syndrome (MetS) represents cardiometabolic dysregulation, defined by hypertension, obesity, diabetes, and dyslipidemia. There remains a significant gap in our understanding of whether MetS impacts outcomes of abdominal body contouring procedures. We aimed to assess the influence of MetS on postoperative outcomes of abdominal body contouring by concurrent abdominoplasty and panniculectomy.

METHODS

The ACS-NSQIP database was utilized to identify patients who underwent concurrent abdominoplasty and panniculectomy procedures from 2012 to 2022. Through propensity score matching, distinct cohorts were established based on the presence of MetS, characterized by patients receiving medical interventions for diabetes mellitus and hypertension, with a body mass index exceeding 30 kg/m. Univariate and multivariate analyses were conducted to evaluate differences between groups.

RESULTS

A total of 14,642 patients underwent abdominal body contouring from 2012 to 2022. Following propensity score matching, 730 patients were included in the analysis, with 365 in each group (MetS vs. non-MetS). Bivariate analysis revealed a longer hospital length of stay (2.3 vs. 1.6 days; p = 0.007) in the MetS cohort compared to the non-MetS cohort. Patients diagnosed with MetS had an average length of stay of 0.6 days longer than non-MetS patients (95% CI [0.17, 1.01]; p = 0.007). No noteworthy disparities were observed in the rates of 30-day wound complications, mild systemic, and severe systemic complications, and readmission rates between the groups.

CONCLUSIONS

Our findings suggest that abdominal body contouring remains a secure option for patients with MetS. Nonetheless, the longer hospital length stays observed in patients with MetS may translate to increased overall costs to the healthcare system. Continued research is warranted to comprehensively assess the economic implications of MetS in the context of abdominal body contouring.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266 .

摘要

背景

代谢综合征(MetS)代表着心血管代谢失调,其特征为高血压、肥胖、糖尿病和血脂异常。我们对代谢综合征是否会影响腹部整形手术的结果仍知之甚少。本研究旨在评估代谢综合征对同期行腹部整形术和腹部皮瓣切除术的腹部形体塑造手术术后结果的影响。

方法

利用美国外科医师学会国家外科质量改进计划(ACS-NSQIP)数据库,从 2012 年至 2022 年期间,确定同时接受腹部整形术和腹部皮瓣切除术的患者。通过倾向评分匹配,根据是否存在代谢综合征建立了两个不同的队列,即代谢综合征组和非代谢综合征组。特征为接受糖尿病和高血压药物治疗,且体重指数(BMI)超过 30kg/m²。通过单变量和多变量分析评估组间差异。

结果

2012 年至 2022 年期间,共有 14642 名患者接受了腹部形体塑造手术。在进行倾向评分匹配后,共有 730 名患者被纳入分析,每组 365 名(代谢综合征组与非代谢综合征组)。双变量分析显示,与非代谢综合征组相比,代谢综合征组患者的住院时间更长(2.3 天比 1.6 天;p=0.007)。与非代谢综合征患者相比,代谢综合征患者的平均住院时间延长了 0.6 天(95%CI[0.17,1.01];p=0.007)。两组间 30 天伤口并发症、轻度全身和重度全身并发症及再入院率无显著差异。

结论

我们的研究结果表明,代谢综合征患者行腹部形体塑造手术仍然是安全的选择。然而,代谢综合征患者住院时间较长可能会导致医疗系统整体成本增加。需要进一步研究来全面评估代谢综合征在腹部形体塑造中的经济影响。

证据等级 III:本杂志要求作者为每篇文章指定一个证据等级。如需全面了解这些循证医学评级,请参考目录或在线投稿指南 www.springer.com/00266

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