Abstract：
BACKGROUND: Capsular contracture (CC) is a common complication following implant-based breast surgery, often requiring surgical intervention. Yet, little is known about risk factors and outcomes following CC surgery.
METHODS: We reviewed the American College of Surgeons National Surgical Quality Improvement Program database (2008-2021) to identify female patients diagnosed with CC and treated surgically. Outcomes of interest included the incidence of surgical and medical complications at 30-days, reoperations, and readmissions. Confounder-adjusted multivariable analyses were performed to establish risk factors.
RESULTS: 5,057 patients with CC were identified (mean age: 55 ± 12 years and mean body mass index [BMI]: 26 ± 6 kg/m2). While 2,841 (65%) women underwent capsulectomy, capsulotomy was performed in 742 patients (15%). Implant removal and replacement were recorded in 1,160 (23%) and 315 (6.2%) cases, respectively. 319 (6.3%) patients experienced postoperative complications, with 155 (3.1%) reoperations and 99 (2.0%) readmissions. While surgical adverse events were recorded in 139 (2.7%) cases, 86 (1.7%) medical complications occurred during the 30 day follow-up. In multivariate analyses, increased BMI (OR: 1.04; p = 0.009), preoperative diagnosis of hypertension (OR: 1.48; p = 0.004), and inpatient setting (OR: 4.15; p < 0.001) were identified as risk factors of complication occurrence.
CONCLUSIONS: Based on 14 years of multi-institutional data, we calculated a net 30 day complication rate of 6.3% after the surgical treatment of CC. We identified higher BMI, hypertension, and inpatient setting as independent risk factors of postoperative complications. Plastic surgeons may wish to integrate these findings into their perioperative workflows, thus optimizing patient counseling and determining candidates\' eligibility for CC surgery.
METHODS: 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 .
METHODS: We reviewed the American College of Surgeons National Surgical Quality Improvement Program database (2008-2021) to identify female patients diagnosed with CC and treated surgically. Outcomes of interest included the incidence of surgical and medical complications at 30-days, reoperations, and readmissions. Confounder-adjusted multivariable analyses were performed to establish risk factors.
RESULTS: 5,057 patients with CC were identified (mean age: 55 ± 12 years and mean body mass index [BMI]: 26 ± 6 kg/m2). While 2,841 (65%) women underwent capsulectomy, capsulotomy was performed in 742 patients (15%). Implant removal and replacement were recorded in 1,160 (23%) and 315 (6.2%) cases, respectively. 319 (6.3%) patients experienced postoperative complications, with 155 (3.1%) reoperations and 99 (2.0%) readmissions. While surgical adverse events were recorded in 139 (2.7%) cases, 86 (1.7%) medical complications occurred during the 30 day follow-up. In multivariate analyses, increased BMI (OR: 1.04; p = 0.009), preoperative diagnosis of hypertension (OR: 1.48; p = 0.004), and inpatient setting (OR: 4.15; p < 0.001) were identified as risk factors of complication occurrence.
CONCLUSIONS: Based on 14 years of multi-institutional data, we calculated a net 30 day complication rate of 6.3% after the surgical treatment of CC. We identified higher BMI, hypertension, and inpatient setting as independent risk factors of postoperative complications. Plastic surgeons may wish to integrate these findings into their perioperative workflows, thus optimizing patient counseling and determining candidates\' eligibility for CC surgery.
METHODS: 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 .
摘要：
背景：囊状挛缩（CC）是基于植入物的乳房手术后的常见并发症，通常需要手术干预。然而，对CC手术后的危险因素和结局知之甚少.
方法：我们回顾了美国外科医生学会国家外科质量改善计划数据库（2008-2021），以确定诊断为CC并接受手术治疗的女性患者。感兴趣的结果包括30天手术和内科并发症的发生率，重新操作,和再入院。进行混淆校正多变量分析以确定危险因素。
结果：确定了5,057例CC患者（平均年龄：55±12岁，平均体重指数[BMI]：26±6kg/m2）。虽然2,841（65％）妇女接受了囊切除术，742例患者(15%)进行了囊切开术.在1,160例（23％）和315例（6.2％）中记录了植入物的去除和更换，分别。319例（6.3%）患者出现术后并发症，155例（3.1%）再次手术和99例（2.0%）再次手术。而手术不良事件记录在139例（2.7％），在30天的随访中发生了86例（1.7％）医学并发症。在多变量分析中，BMI增加（OR：1.04；p=0.009），术前诊断为高血压（OR：1.48；p=0.004），和住院设置（OR：4.15;p<0.001）被确定为并发症发生的危险因素。
结论：基于14年的多机构数据，我们计算出手术治疗CC后30天的净并发症率为6.3％。我们确定了更高的BMI，高血压,住院设置为术后并发症的独立危险因素。整形外科医生可能希望将这些发现整合到他们的围手术期工作流程中，从而优化患者咨询并确定接受CC手术的候选人资格。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：我们回顾了美国外科医生学会国家外科质量改善计划数据库（2008-2021），以确定诊断为CC并接受手术治疗的女性患者。感兴趣的结果包括30天手术和内科并发症的发生率，重新操作,和再入院。进行混淆校正多变量分析以确定危险因素。
结果：确定了5,057例CC患者（平均年龄：55±12岁，平均体重指数[BMI]：26±6kg/m2）。虽然2,841（65％）妇女接受了囊切除术，742例患者(15%)进行了囊切开术.在1,160例（23％）和315例（6.2％）中记录了植入物的去除和更换，分别。319例（6.3%）患者出现术后并发症，155例（3.1%）再次手术和99例（2.0%）再次手术。而手术不良事件记录在139例（2.7％），在30天的随访中发生了86例（1.7％）医学并发症。在多变量分析中，BMI增加（OR：1.04；p=0.009），术前诊断为高血压（OR：1.48；p=0.004），和住院设置（OR：4.15;p<0.001）被确定为并发症发生的危险因素。
结论：基于14年的多机构数据，我们计算出手术治疗CC后30天的净并发症率为6.3％。我们确定了更高的BMI，高血压,住院设置为术后并发症的独立危险因素。整形外科医生可能希望将这些发现整合到他们的围手术期工作流程中，从而优化患者咨询并确定接受CC手术的候选人资格。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
