背景:术前乳房满意度在乳房切除术后乳房重建(PMBR)患者术后过程中的作用尚不清楚。这项研究的目的是了解术前评分对术后结局的影响作为自变量。
方法:我们检查了在2017年至2021年期间接受PMBR的患者,并在术后1年完成了对乳房的BREAST-Q满意度。两个多元线性回归模型(模型1为术前乳房满意度评分,模型2为术前乳房满意度评分),似然比测试,简单的t统计量,和样本患者数据集以预测1年评分。使用多次插补来解释术前评分的缺失。
结果:总体而言,包括2324例患者。模型1显示,术前评分与术后评分显着相关(β=0.09,95%置信区间0.04-0.14;p<0.001)。比较模型1和模型2表明,在回归中包括术前乳房满意度可显着提高模型拟合度(检验统计量=10.04;p=0.0021)。使用t统计量的绝对值作为线性回归中变量重要性的度量,术前评分的重要性被量化为3.39-比新辅助放疗更重要,乳房切除术的重量,身体质量指数,双侧预防性乳房切除术,和种族,但低于辅助辐射,重建类型,和精神病诊断。
结论:术前乳房满意度评分是PMBR术后满意度的重要独立预测因素。就像手术前仔细记录生命体征和工作一样,应收集术前评分以预先评估患者的满意度并优化术后结局.
BACKGROUND: The role that preoperative Satisfaction with Breast plays in a patient\'s postoperative course after postmastectomy breast reconstruction (PMBR) is not understood. The aim of this study is to understand the impact of the preoperative score on postoperative outcome as an independent variable.
METHODS: We examined patients who underwent PMBR between 2017 and 2021 and who completed the BREAST-Q Satisfaction with Breasts at 1 year postoperatively. Two multiple linear regression models (Model 1 with the preoperative Satisfaction with Breasts score and Model 2 without the preoperative score), likelihood ratio tests, simple t-statistics, and sample patient dataset to predict the 1 year score were performed. Multiple imputation was used to account for missing preoperative scores.
RESULTS: Overall, 2324 patients were included. Model 1 showed that the preoperative score is significantly associated with the postoperative score (β = 0.09, 95% confidence interval 0.04-0.14; p < 0.001). Comparing Model 1 and Model 2 demonstrated that including preoperative Satisfaction with Breasts in a regression significantly improves model fit (test statistic = 10.04; p = 0.0021). Using the absolute value of the t-statistics as a measure of variable importance in linear regression, the importance of the preoperative score was quantified as 3.39-more important than neoadjuvant radiation, mastectomy weight, body mass index, bilateral prophylactic mastectomy, and race, but less than adjuvant radiation, reconstruction type, and psychiatric diagnoses.
CONCLUSIONS: Preoperative Satisfaction with Breasts scores are an important independent predictor of postoperative satisfaction after PMBR. Just as vital sign and work-up are carefully documented before surgery, preoperative scores should be collected to pre-emptively gauge patients\' satisfaction and optimize postoperative outcomes.