Melero-Fernández Cristina, Martínez-Martínez Ana Belén
Breast Unit, Lozano Blesa University Hospital, Zaragoza, Spain.
Department of Nursing and Physiatry, Health Sciences Faculty, University of Zaragoza, C/Domingo Miral, s/n., 50.009, Zaragoza, Spain.
Aesthetic Plast Surg. 2025 Aug;49(15):4256-4264. doi: 10.1007/s00266-025-04831-x. Epub 2025 Apr 3.
This study introduces a new Gigantomastia Preference Score (GPS) to prioritize surgical candidates based on clinical severity and quality of life impact.
This retrospective study applied the newly developed GPS to the existing surgery waiting list of 213 patients at our center. The GPS was developed from evidence-based clinical practice indicators and a thorough literature review, selecting nine variables. The GPS was then used to reorder the waiting list, and comparisons were made between the original and reordered lists.
Implementation of the GPS significantly reordered the waiting list. The Spearman's Rank Correlation coefficient between the original and new rankings was 0.5679 (p-value = 1.38e-19), indicating a moderate to strong positive correlation. The Wilcoxon Signed-Rank Test yielded a statistic of 3485.0 (p-value = 8.44e-21), showing significant changes in patient positions. ANOVA results highlighted significant differences in BMI and largest breast weight across priority levels. Chi-Square tests revealed significant associations between priority levels and Trauma and Psychiatry reports.
The GPS significantly improved the prioritization of patients with gigantomastia by incorporating multiple clinically relevant factors. This led to a more equitable and informed ordering of the surgical waiting list, potentially improving patient outcomes and optimizing healthcare resource allocation.
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 .
本研究引入了一种新的巨乳症偏好评分（GPS），以根据临床严重程度和对生活质量的影响对手术候选人进行优先排序。
这项回顾性研究将新开发的GPS应用于我们中心213名患者的现有手术等候名单。GPS是根据循证临床实践指标和全面的文献综述制定的，选择了九个变量。然后使用GPS对等候名单重新排序，并对原始名单和重新排序后的名单进行比较。
GPS的实施显著地重新排列了等候名单。原始排名与新排名之间的斯皮尔曼等级相关系数为0.5679（p值 = 1.38e - 19），表明存在中度至强的正相关。威尔科克森符号秩检验得出的统计量为3485.0（p值 = 8.44e - 21），表明患者排名有显著变化。方差分析结果突出了不同优先级水平在体重指数和最大乳房重量方面的显著差异。卡方检验揭示了优先级水平与创伤和精神病学报告之间存在显著关联。
GPS通过纳入多个临床相关因素，显著改善了巨乳症患者的优先排序。这导致手术等候名单的排序更加公平且合理，有可能改善患者预后并优化医疗资源分配。
证据等级IV：本期刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南 www.springer.com/00266 。
