Abdominal Contouring
| Autor: | Matthew Doscher, Olatomide Familusi, Oscar J. Manrique, Joseph H. Shin, Teresa Benacquista |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Databases Factual medicine.medical_treatment Clinical Decision-Making 030230 surgery Logistic regression Risk Assessment Decision Support Techniques 03 medical and health sciences Postoperative Complications 0302 clinical medicine Anesthesiology Risk Factors Odds Ratio Health Status Indicators Humans Medicine Societies Medical Aged Abdominoplasty business.industry Patient Selection Mortality rate General surgery Odds ratio Evidence-based medicine Middle Aged United States Surgery Logistic Models 030220 oncology & carcinogenesis Female business Risk assessment Complication |
| Zdroj: | Plastic and Reconstructive Surgery. 138:1211-1220 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000002761 |
| Popis: | BACKGROUND The purpose of this study was to determine whether the American Society of Anesthesiologists classification system could be used preoperatively to identify patients at high risk for complications after abdominal contouring. METHODS Using the National Surgical Quality Improvement Program database from 2007 to 2012, patients undergoing abdominal contouring procedures were identified and stratified by American Society of Anesthesiologists class. The primary outcome was any complication within 30 days. Secondary outcomes included minor wound, major surgical, and medical complication. Adjusted odds ratios were calculated using logistic regression. RESULTS A total of 3637 patients were analyzed; 14.6 percent of patients were class I, 59.1 percent were class II, 23.4 percent were class III, and 2.9 percent were class IV. Overall complication and mortality rates were 12 percent and 0.2 percent, respectively. There was a significant trend of increasing odds of any complication with increasing class (class I, OR, 1.0; class II, OR, 1.5; class III, OR, 2.5; class IV, OR, 5.6; p-trend < 0.001). This trend was seen consistently for minor wound complications, medical complications, and major surgical complications (p = 0.007, p = 0.005, and p = 0.001, respectively). CONCLUSIONS The American Society of Anesthesiologists classification system, which is simple and universally applicable, appears to predict significant complications and can be used to rapidly screen patients before abdominal contouring. Furthermore, the authors' results can be used to inform patient-physician discussion about the risks incurred when undergoing these procedures based on their individual class. Together with optimization of high-risk patients, patient selection using American Society of Anesthesiologists classification may prevent complications and improve outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, II. |
| Databáze: | OpenAIRE |
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