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The effect of new inclusion criteria on patient selection for reduction mammaplasty

机译：新纳入标准对减少乳房成形术患者选择的影响

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Purpose - To evaluate the impact of rationing guidelines on the practice of reduction mammaplasty, with particular reference to patient selection. Design/methodology/approach - A retrospective audit was performed. Patients who were accepted for surgery in the first nine months following the date of publication of new and explicit inclusion criteria were compared with patients who were accepted for surgery in the 15 months preceding publication. Findings - Of 131 consecutive patients, 98 were accepted before publication of the inclusion criteria, with 33 after. A total of the 97 of 98 and 33 of 33 were symptomatic. Conformity to criteria for body mass index (BMI) increased from 65 of 98 (66 per cent) to 25 of 33 (76 per cent, p = 0.143) Attendance at pre-operative breast seminar increased from 72 of 98 (73 per cent) to 29 of 33 (88 per cent, p = 0.099). Incidence of smoking increased from 18 of 98 (18 per cent) to 7 of 33 (21 per cent, p = 0.799). Patients under the age of 30 accounted for this increase. The number of cases who failed on more than one criterion fell from 17 of 98 (7 per cent) to 2 of 33 (3 per cent, p = 0.155). Practical implications - Demonstrates a non-significant reduction in the number of obese patients being accepted for surgery, and a non-significant increase in uptake of pre-operative nurse led seminars in the practice. Since publication of the inclusion criteria, all but one of the patients accepted for surgery with exclusion criteria failed on the basis one criterion only. Not successful in enforcing abstinence from smoking as a condition for surgery, particularly among younger patients. To help do this objective ways to assess smoking status need to be looked at. A re-audit is required to complete the loop. Originality/value - This is the first paper to present audit results for the new inclusion criteria for reduction mammaplasty.
机译：目的-评估配给准则对减少乳房成形术的影响，特别是针对患者的选择。设计/方法/方法-进行了追溯审核。将在发布新的明确纳入标准之后的前九个月接受手术的患者与在发布前15个月接受手术的患者进行比较。调查结果-在131例连续患者中，有98例在入选标准公布之前被接受，33例在入选标准公布之前。共有98例中的97例和33例中的33例有症状。符合体重指数（BMI）的标准从98中的65（66％）增加到33中的25（76％，p = 0.143）乳腺癌术前研讨会的出席率从98中的72（73％）增加至33中的29（88％，p = 0.099）。吸烟率从98的18（18％）增加到33的7（21％，p = 0.799）。 30岁以下的患者占了这一增加。未能通过一项以上标准的案件数量从98例中的17例（7％）降至33例中的2例（3％，p = 0.155）。实际意义-证明接受手术的肥胖患者数量没有显着减少，而在实践中，由护士主持的术前研讨会的摄取却没有显着增加。自从纳入标准公布以来，接受手术但接受排除标准的除一名患者外，所有患者仅根据一项标准就失败了。在禁止戒烟作为手术条件方面没有取得成功，特别是在年轻患者中。为了帮助做到这一点，需要研究评估吸烟状况的客观方法。需要重新审核才能完成循环。原创性/价值-这是第一篇介绍减少乳房成形术新纳入标准的审计结果的论文。

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