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首页> 外文期刊>Plastic and reconstructive surgery >Obesity and Breast Reconstruction: Complications and Patient-Reported Outcomes in a Multicenter, Prospective Study
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Obesity and Breast Reconstruction: Complications and Patient-Reported Outcomes in a Multicenter, Prospective Study

机译：肥胖和乳房重建：多中心，前瞻性研究中的并发症和患者报告的结果

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摘要

Background: The authors’ purpose was to evaluate the effects of body mass index, as defined by World Health Organization criteria, on complications and patient-reported outcomes in implant-based and autologous breast reconstruction. Methods: Complications and BREAST-Q patient-reported outcomes were analyzed 2 years after breast reconstruction for women from 11 participating sites. Separate mixed-effects regressions were performed to assess body mass index effects on outcomes. Results: A total of 2259 patients (1625 implant-based and 634 autologous) were included. Women with class II/III obesity had higher risks of any complication in both the implant (OR, 1.66; p = 0.03) and autologous (OR, 3.35; p < 0.001) groups, and higher risks of major complications in both the implant (OR, 1.71, p = 0.04) and autologous (OR, 2.72; p = 0.001) groups, compared with underweight/normal weight patients. Both class I (OR, 1.97; p = 0.03) and class II/III (OR, 3.30; p = 0.001) obesity patients experienced higher reconstructive failures in the implant cohort. Class I obesity implant patients reported significantly lower Satisfaction with Breasts scores (mean difference, –5.37; p = 0.007). Body mass index did not significantly affect patient-reported outcomes for autologous reconstruction patients. Conclusions: Obesity was associated with higher risks for complications in both implant-based and autologous breast reconstruction; however, it only significantly affected reconstruction failure and patient-reported outcomes in the implant reconstruction patients. Quality-of-life benefits and surgical risk should be presented to each patient as they relate to her body mass index, to optimize shared decision-making for breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, I.
机译：背景：作者的目的是评估体重指数的影响，如世界卫生组织的基于植入和自体乳房重建中的并发症和患者报告的结果。方法：在11名参与场地的妇女乳房重建后2年分析了并发症和乳腺Q患者报告的结果。进行单独的混合效应回归以评估对结果的体重指数效应。结果：共有2259名患者（1625名植入物和634个自体）。 II / III类肥胖的妇女在植入物（或1.66; p = 0.03）和自体（或3.35; p <0.001）组中具有更高的任何并发症的风险，以及植入物中的主要并发症的风险较高（或者，1.71，p = 0.04）和自体（或2.72; p = 0.001）组，与体重/正常重量患者相比。 I类（或1.97; p = 0.03）和II / III类（或3.30; p = 0.001）肥胖症患者在植入队中经历了更高的重建失败。 I类肥胖植入患者报告的乳房分数的满意度显着降低（平均差异，-5.37; p = 0.007）。体重指数没有显着影响自体重建患者的患者报告的结果。结论：植入基于植入物和自体乳腺重建的并发症风险较高有关;然而，它只会显着影响植入物重建患者的重建失败和患者报告的结果。当患者与体重指数相关时，应呈现生活质量效益和外科风险，以优化乳房重建的共同决策。临床问题/证据水平：风险，I。

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  • 来源
    《Plastic and reconstructive surgery》 |2020年第3期|共10页
  • 作者

    Dhivya R. Srinivasa; Mark W. Clemens; Ji Qi; Jennifer B. Hamill; Hyungjin M. Kim; Andrea L. Pusic; Edwin G. Wilkins; Charles E. Butler; Patrick B. Garvey;

  • 作者单位

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

    From the Section of Plastic Surgery and the Department of Biostatistics University of Michigan;

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  • 正文语种 eng
  • 中图分类 整形外科学（修复外科学）;
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