BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?

Raimund Winter, Frederike Reischies, Alexandru Tuca, Paul Wurzer, Christian Schubert, Christina Wolfsberger, Theresa Margarethe Rienmüller, Herwig Friedl, Michaela Sljivich, Lars-P. Kamolz

Publikation: Beitrag in einer FachzeitschriftArtikelForschungBegutachtung

Abstract

We aimed to evaluate the interaction between individual risk factors and institutional complication rates after reduction mammaplasties to develop a chart for a personalized written patient informed consent.
We retrospectively reviewed charts of 804 patients who underwent bilateral breast reduction between 2005 and 2015. The Clavien-Dindo classification was used to classify postoperative complications. Relevant predictors were found by applying a stepwise variable selection procedure. Multilevel predictors were assessed through chi-square tests on the respective deviance reductions.
486 patients were included. The most common complications were wound healing problems (n=270/56%), foreign body reactions (n=58/12%), wound infections (n=45/9,3%) and fat tissue necrosis (n= 41/8%). The risk factors for the personalized patient chart for the most common complications influencing the preoperative informed consent were: smoking, operative technique, resection weight for wound healing problems; body mass index and allergies for wound infections; and patients’ age, resection weight for fat tissue necrosis.
The resultant chart of institutionally encountered most common complications based on individual risk factors is a graphical template for obtaining patient informed consent in the future. Whether this approach influences patient information retainment, incidence of filed lawsuits or behavioral change needs to be prospectively tested in future studies.
Originalspracheenglisch
FachzeitschriftNature Scientific Reports
PublikationsstatusAngenommen/In Druck - 15 Aug 2019

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Informed Consent
Breast
Weights and Measures
Fat Necrosis
Wound Infection
Wound Healing
Foreign-Body Reaction
Mammaplasty
Chi-Square Distribution
Hypersensitivity
Body Mass Index
Smoking
Incidence

Dies zitieren

Winter, R., Reischies, F., Tuca, A., Wurzer, P., Schubert, C., Wolfsberger, C., ... Kamolz, L-P. (Angenommen/Im Druck). BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery? Nature Scientific Reports.

BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery? / Winter, Raimund; Reischies, Frederike; Tuca, Alexandru; Wurzer, Paul; Schubert, Christian; Wolfsberger, Christina; Rienmüller, Theresa Margarethe; Friedl, Herwig; Sljivich, Michaela; Kamolz, Lars-P.

in: Nature Scientific Reports, 15.08.2019.

Publikation: Beitrag in einer FachzeitschriftArtikelForschungBegutachtung

Winter, Raimund ; Reischies, Frederike ; Tuca, Alexandru ; Wurzer, Paul ; Schubert, Christian ; Wolfsberger, Christina ; Rienmüller, Theresa Margarethe ; Friedl, Herwig ; Sljivich, Michaela ; Kamolz, Lars-P. / BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?. in: Nature Scientific Reports. 2019.
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title = "BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?",
abstract = "We aimed to evaluate the interaction between individual risk factors and institutional complication rates after reduction mammaplasties to develop a chart for a personalized written patient informed consent.We retrospectively reviewed charts of 804 patients who underwent bilateral breast reduction between 2005 and 2015. The Clavien-Dindo classification was used to classify postoperative complications. Relevant predictors were found by applying a stepwise variable selection procedure. Multilevel predictors were assessed through chi-square tests on the respective deviance reductions.486 patients were included. The most common complications were wound healing problems (n=270/56{\%}), foreign body reactions (n=58/12{\%}), wound infections (n=45/9,3{\%}) and fat tissue necrosis (n= 41/8{\%}). The risk factors for the personalized patient chart for the most common complications influencing the preoperative informed consent were: smoking, operative technique, resection weight for wound healing problems; body mass index and allergies for wound infections; and patients’ age, resection weight for fat tissue necrosis.The resultant chart of institutionally encountered most common complications based on individual risk factors is a graphical template for obtaining patient informed consent in the future. Whether this approach influences patient information retainment, incidence of filed lawsuits or behavioral change needs to be prospectively tested in future studies.",
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AU - Tuca, Alexandru

AU - Wurzer, Paul

AU - Schubert, Christian

AU - Wolfsberger, Christina

AU - Rienmüller, Theresa Margarethe

AU - Friedl, Herwig

AU - Sljivich, Michaela

AU - Kamolz, Lars-P.

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N2 - We aimed to evaluate the interaction between individual risk factors and institutional complication rates after reduction mammaplasties to develop a chart for a personalized written patient informed consent.We retrospectively reviewed charts of 804 patients who underwent bilateral breast reduction between 2005 and 2015. The Clavien-Dindo classification was used to classify postoperative complications. Relevant predictors were found by applying a stepwise variable selection procedure. Multilevel predictors were assessed through chi-square tests on the respective deviance reductions.486 patients were included. The most common complications were wound healing problems (n=270/56%), foreign body reactions (n=58/12%), wound infections (n=45/9,3%) and fat tissue necrosis (n= 41/8%). The risk factors for the personalized patient chart for the most common complications influencing the preoperative informed consent were: smoking, operative technique, resection weight for wound healing problems; body mass index and allergies for wound infections; and patients’ age, resection weight for fat tissue necrosis.The resultant chart of institutionally encountered most common complications based on individual risk factors is a graphical template for obtaining patient informed consent in the future. Whether this approach influences patient information retainment, incidence of filed lawsuits or behavioral change needs to be prospectively tested in future studies.

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