Abstract：
BACKGROUND: Gender affirming surgeries (GAS), such as phalloplasty (PLPs) and vaginoplasty (VGPs), are important aspects of medical care for transgender patients. Here, we aim to better characterize patient demographics and surgical outcomes for PLPs and VGPs using the National Surgical Quality Improvement Program (NSQIP). We hypothesized that frailty indices would be predictive of perioperative PLP and VGP risk and outcomes for PLPs and VGPs.
METHODS: Primary GAS, specifically PLPs and VGPs performed from 2006-2020 were identified in NSQIP. Baseline frailty was based on NSQIP\'s modified frailty index (mFI) and preoperative morbidity probability (morbprob) variable.
RESULTS: Fifty-eight PLPs and 468 VGPs were identified. The overall 30-day complication rate for PLP was 26%, with 17% of total patients experiencing minor complications and 16% experiencing major complications. The overall, minor, and major complication rates for VGP were 14%, 7%, and 9% respectively. Readmissions and reoperations occurred in 7% PLP and 5% VGP patients. No deaths occurred in either group within 30 days. The mFI scores were not predictive of 30-day complications or LOS. NSQIP morbprob was predictive of 30-day complications for both PLP (OR 4.0, 95% CI 1.08-19.59, p = 0.038) and VGP (OR 2.39, 95% CI 1.46-3.97, p = 0.0005). NSQIP\'s morbprob was also predictive of extended LOS for PLP patients (6.3 ± 1.3 days, p = 0.03).
CONCLUSIONS: This study describes patient characteristics and complication rates of PLPs and VGPs. The NSQIP preoperative morbprob is an effective predictor of surgical complications and is better than the mFI.
METHODS: Primary GAS, specifically PLPs and VGPs performed from 2006-2020 were identified in NSQIP. Baseline frailty was based on NSQIP\'s modified frailty index (mFI) and preoperative morbidity probability (morbprob) variable.
RESULTS: Fifty-eight PLPs and 468 VGPs were identified. The overall 30-day complication rate for PLP was 26%, with 17% of total patients experiencing minor complications and 16% experiencing major complications. The overall, minor, and major complication rates for VGP were 14%, 7%, and 9% respectively. Readmissions and reoperations occurred in 7% PLP and 5% VGP patients. No deaths occurred in either group within 30 days. The mFI scores were not predictive of 30-day complications or LOS. NSQIP morbprob was predictive of 30-day complications for both PLP (OR 4.0, 95% CI 1.08-19.59, p = 0.038) and VGP (OR 2.39, 95% CI 1.46-3.97, p = 0.0005). NSQIP\'s morbprob was also predictive of extended LOS for PLP patients (6.3 ± 1.3 days, p = 0.03).
CONCLUSIONS: This study describes patient characteristics and complication rates of PLPs and VGPs. The NSQIP preoperative morbprob is an effective predictor of surgical complications and is better than the mFI.
摘要：
背景：性别确认手术（GAS），如阴道成形术(PLPs)和阴道成形术(VGP)，是跨性别患者医疗护理的重要方面。这里,我们的目标是使用国家手术质量改善计划(NSQIP)更好地表征PLP和VGP的患者人口统计学特征和手术结局.我们假设虚弱指数可以预测围手术期PLP和VGP的风险和结果。
方法：主要气体，特别是在NSQIP中确定了2006-2020年进行的PLP和VGP。基线虚弱基于NSQIP的修正虚弱指数(mFI)和术前发病概率(morbprob)变量。
结果：确定了58个PLP和468个VGP。PLP的30天并发症发生率为26%，总患者中有17％出现轻微并发症，16％出现严重并发症。总体来说,未成年人,VGP的主要并发症发生率为14%，7%,分别为9%。7％的PLP和5％的VGP患者再次入院和再次手术。两组在30天内均未发生死亡。mFI评分不能预测30天并发症或LOS。NSQIPmorbprob可预测PLP（OR4.0，95％CI1.08-19.59，p=0.038）和VGP（OR2.39，95％CI1.46-3.97，p=0.0005）的30天并发症。NSQIP的morbprob也可预测PLP患者的LOS延长(6.3±1.3天，p=0.03)。
结论：本研究描述了PLPs和VGPs的患者特征和并发症发生率。NSQIP术前morbprob是手术并发症的有效预测因子，优于mFI。
方法：主要气体，特别是在NSQIP中确定了2006-2020年进行的PLP和VGP。基线虚弱基于NSQIP的修正虚弱指数(mFI)和术前发病概率(morbprob)变量。
结果：确定了58个PLP和468个VGP。PLP的30天并发症发生率为26%，总患者中有17％出现轻微并发症，16％出现严重并发症。总体来说,未成年人,VGP的主要并发症发生率为14%，7%,分别为9%。7％的PLP和5％的VGP患者再次入院和再次手术。两组在30天内均未发生死亡。mFI评分不能预测30天并发症或LOS。NSQIPmorbprob可预测PLP（OR4.0，95％CI1.08-19.59，p=0.038）和VGP（OR2.39，95％CI1.46-3.97，p=0.0005）的30天并发症。NSQIP的morbprob也可预测PLP患者的LOS延长(6.3±1.3天，p=0.03)。
结论：本研究描述了PLPs和VGPs的患者特征和并发症发生率。NSQIP术前morbprob是手术并发症的有效预测因子，优于mFI。
