Incidence and Preoperative Risk Factors for Major Complications After Capsulectomy: Analysis of 3,048 Patients

2022 ◽  
Author(s):  
Ashkan Afshari ◽  
Lyly Nguyen ◽  
Gabriella E Glassman ◽  
Galen Perdikis ◽  
James C Grotting ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cosmetic Surgery ◽  
Breast Implant ◽  
Major Complication ◽  
Implant Removal ◽  
Class Iii ◽  
Public Attention ◽  
Preoperative Risk Factors ◽  
Major Complications ◽  
Insurance Database

Abstract Background While there are many indications for periprosthetic breast capsulectomy, heightened public attention surrounding breast implant illness has resulted in increased rates of capsulectomy. Objectives This study aims to identify the incidence of major complications and risk factors associated with capsulectomy. Methods Using a prospectively enrolled cosmetic surgery insurance database, CosmetAssure (Birmingham, AL, USA), patients undergoing capsulectomy between January 2, 2017 and July 31, 2019 were identified. Outcomes measured included the occurrence of and risk factors for major complication(s) necessitating an emergency department visit, hospitalization, or reoperation within 45 postoperative days. Results Among 76,128 patients evaluated, 3048 (4.0%) underwent capsulectomy. There was a significant increase in number of capsulectomies following January 6, 2019 (2.7/day vs 5.2/day, p<0.05). Capsulectomy patients had more likely to have any complication and specifically hematoma than those undergoing breast implant removal or replacement without capsulectomy (2.8% vs 1.9% and 1.6% vs 0.9%, respectively, p<0.05). Eighty-four (2.8%) developed at least one complication. The most common complications included hematoma (1.6%) followed by infection (0.5%). ASA class III/IV was an independent risk factor for any complication and BMI ≥30 and office-based surgical suites were risk factors for infection. Conclusions There is a growing number of capsulectomies being performed. The most common major complication is hematoma. Patients undergoing capsulectomy confer a higher complication rate compared to those undergoing breast implant removal or replacement without capsulectomy. Patients should be counseled regarding the potential for major complications.

scholarly journals Cosmetic Liposuction: Preoperative Risk Factors, Major Complication Rates, and Safety of Combined Procedures

2017 ◽  
Vol 37 (6) ◽  
pp. 680-694 ◽  
Author(s):  
Christodoulos Kaoutzanis ◽  
Varun Gupta ◽  
Julian Winocour ◽  
John Layliev ◽  
Roberto Ramirez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Complication ◽  
Complication Rates ◽  
Preoperative Risk ◽  
Combined Procedures ◽  
Preoperative Risk Factors

scholarly journals Incidence and Preoperative Risk Factors for Major Complications in Aesthetic Rhinoplasty: Analysis of 4978 Patients

2017 ◽  
Vol 37 (7) ◽  
pp. 757-767 ◽  
Author(s):  
John Layliev ◽  
Varun Gupta ◽  
Christodoulos Kaoutzanis ◽  
Nishant Ganesh Kumar ◽  
Julian Winocour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preoperative Risk ◽  
Preoperative Risk Factors ◽  
Major Complications ◽  
Aesthetic Rhinoplasty

Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs

2014 ◽  
Vol 27 (04) ◽  
pp. 263-270 ◽  
Author(s):  
M. Havlicek ◽  
N. R. Perkins ◽  
D. R. James ◽  
S. M. Fearnside ◽  
A. M. Marchevsky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kirschner Wire ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Sartorius Muscle ◽  
Kirschner Wires ◽  
Major Complications ◽  
Fold Reduction ◽  
Tension Bands

SummaryDogs treated for congenital medial patellar luxation were reviewed for the purpose of determining the incidence of postoperative major complications requiring surgical revision and the risk factors for their occurrence. Major complications occurred in 18.5% of the patellar luxation stabilization procedures with implant associated complications being the most frequent, patellar reluxation the second, and tibial tuberosity avulsion the third most common major complication. Other complications included patellar ligament rupture and trochlear wedge displacement. When recession trochleoplasty was performed in addition to tibial tuberosity transposition, a 5.1-fold reduction in the rate of patellar reluxation was observed. Release of the cranial belly of the sartorius muscle further reduced the incidence of patellar reluxation, while patella alta (pre- or postoperative) and patellar luxation grade were not found to influence the rate of reluxation. Tibial tuberosity avulsion was 11.1-times more likely when using a single Kirschner wire to stabilize a transposition, compared with two Kirschner wires. Independent to the number of Kirschner wires used, the more caudodistally the Kirschner wires were directed, the higher the risk for tibial tuberosity avulsion. Tension bands were used in 24.4% of the transpositions with no tuberosity avulsion occurring in stifles stabilized with a tension band. Overall, grade 1 luxations had a significantly lower incidence of major complications than other grades, while body weight, age, sex, and bilateral patellar stabilization were not associated with risk of major complication development.

scholarly journals The Interaction between Diabetes, Body Mass Index, Hepatic Steatosis, and Risk of Liver Resection: Insulin Dependent Diabetes Is the Greatest Risk for Major Complications

HPB Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
M. G. Wiggans ◽  
J. T. Lordan ◽  
G. Shahtahmassebi ◽  
S. Aroori ◽  
M. J. Bowles ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Liver Resection ◽  
Hepatic Steatosis ◽  
Significant Risk ◽  
Major Complication ◽  
Significant Risk Factor ◽  
Insulin Dependent Diabetes ◽  
Major Complications ◽  
Insulin Dependent

Background. This study aimed to assess the relationship between diabetes, obesity, and hepatic steatosis in patients undergoing liver resection and to determine if these factors are independent predictors of major complications. Materials and Methods. Analysis of a prospectively maintained database of patients undergoing liver resection between 2005 and 2012 was undertaken. Background liver was assessed for steatosis and classified as <33% and ≥33%. Major complications were defined as Grade III–V complications using the Dindo-Clavien classification. Results. 504 patients underwent liver resection, of whom 56 had diabetes and 61 had steatosis ≥33%. Median BMI was 26 kg/m2 (16–54 kg/m2). 94 patients developed a major complication (18.7%). BMI ≥ 25 kg/m2 (P=0.001) and diabetes (P=0.018) were associated with steatosis ≥33%. Only insulin dependent diabetes was a risk factor for major complications (P=0.028). Age, male gender, hypoalbuminaemia, synchronous bowel procedures, extent of resection, and blood transfusion were also independent risk factors. Conclusions. Liver surgery in the presence of steatosis, elevated BMI, and non-insulin dependent diabetes is not associated with major complications. Although diabetes requiring insulin therapy was a significant risk factor, the major risk factors relate to technical aspects of surgery, particularly synchronous bowel procedures.

Analysis of Risk Factors for Posterior C1 Screw-Related Complication: A Retrospective Study of 358 Posterior C1 Screws

2019 ◽  
Vol 17 (5) ◽  
pp. 509-517 ◽  
Author(s):  
Ho Jun Yi ◽  
Jae Taek Hong ◽  
Jong Beom Lee ◽  
Jong-Hyeok Park ◽  
Jung Jae Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Complication ◽  
Entry Point ◽  
Posterior Arch ◽  
Occipital Neuralgia ◽  
Lateral Mass ◽  
Surgical Experience ◽  
Related Complication ◽  
Major Complications ◽  
Screw Malposition

Abstract BACKGROUND Although C1 screw fixation is becoming popular, only a few studies have discussed about the risk factors and the patterns of C1 screw complications. OBJECTIVE To investigate the incidence of C1 screw complications and analyze the risk factors of the C1 screw complications. METHODS A total of 358 C1 screws in 180 consecutive patients were analyzed for C1 screw complications. Screw malposition, occipital neuralgia, major complications, and total C1 screw complications were analyzed. RESULTS The distribution of C1 screw entry point is as follows: inferior lateral mass, 317 screws (88.5 %); posterior arch (PA), 38 screws (10.7 %); and superior lateral mass, 3 screws (0.8 %). We sacrificed the C2 root for 127 screws (35.5 %). C1 instrumentation induced 3.1 % screw malposition, 6.4 % occipital neuralgia, 0.6 % vascular injury, and 3.4 % major complications. In multivariate analysis, deformity (odds ratio [OR]: 2.10, P = .003), traumatic pathology (OR: 4.97, P = .001), and PA entry point (OR: 3.38, P = .001) are independent factors of C1 screw malposition. C2 root resection can decrease the incidence of C1 screw malposition (OR: 0.38, P = .012), but it is a risk factor of occipital neuralgia (OR: 2.62, P = .034). Advanced surgical experience (OR: 0.09, P = .020) correlated with less major complication. CONCLUSION The incidence of C1 screw complications might not be uncommon, and deformity or traumatic pathology and PA entry point could be the risk factors to total C1 screw complications. The PA screw induces more malposition, but less occipital neuralgia. C2 root resection can reduce screw malposition, but increases occipital neuralgia.

scholarly journals Frequency and risk factors for major complications after stereotactic radiofrequency ablation of liver tumors in 1235 ablation sessions: a 15-year experience

2020 ◽  
Author(s):  
Peter Schullian ◽  
Edward Johnston ◽  
Gregor Laimer ◽  
Daniel Putzer ◽  
Gernot Eberle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Complication Rate ◽  
Tumor Size ◽  
Liver Tumors ◽  
Major Complication ◽  
Major Complications ◽  
History Of ◽  
Major Complication Rate ◽  
Simple Logistic

Abstract Objectives To assess the frequency of major complications after multi-probe stereotactic radiofrequency ablation (SRFA) in a large cohort of patients over 15 years and to elucidate risk factors for adverse events. Materials and methods A retrospective study was carried out between July 2003 and December 2018. Seven hundred ninety-three consecutive patients (median 65.0 years (0.3–88), 241 women and 552 men, were treated in 1235 SRFA sessions for 2475 primary and metastatic liver tumors with a median tumor size of 3.0 cm (0.5–18 cm). The frequency of major complications was evaluated according to SIR guidelines and putative predictors of adverse events analyzed using simple and multivariable logistic regression. Results Thirty-day mortality after SRFA was 0.5% (6/1235) with an overall major complication rate of 7.4% (91/1235). The major complication rate decreased from 11.5% (36/314) (before January 2011) to 6.0% (55/921) (p = 0.001). 50.5% (46/91) of major complications were successfully treated in the same anesthetic session by angiographic coiling for hemorrhage and chest tube insertion for pneumothorax. History of bile duct surgery/intervention, number of coaxial needles, and location of tumors in segment IVa or VIII were independent prognostic factors for major complications following multivariable logistic regression analysis. Simple logistic regression revealed the number of tumors, tumor size, location close to the diaphragm, tumor conglomerate, and segment VII as other significant predictors. Conclusion SRFA of liver tumors is safe and can extend the treatment spectrum of conventional RFA. Adaptations over time combined with increasing experience resulted in a significant decrease in complications. Key Points • In 1235 ablation sessions in 793 patients over 15 years, we found a mortality rate of 0.5% (6/1235) and an overall major complication rate of 7.4%, which fell from 11.5 (36/314) to 6.0% (55/921, p = 0.001) after January 2011, likely due to procedural adaptations. • History of bile duct surgery/intervention (p = 0.013, OR = 3.290), number of coaxial needles (p = 0.026, OR = 1.052), and location of tumors in segment IVa (p = 0.016, OR = 1.989) or VIII (p = 0.038, OR = 1.635) were found to be independent prognostic factors. • Simple logistic regression revealed that number of tumors, tumor size, location close to the diaphragm, tumor conglomerates, and segment VII were other significant predictors of major complications.

scholarly journals Perioperative Evaluation of Patient Outcomes after Severe Acid Corrosive Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Ming-Ho Wu ◽  
Han-Yun Wu
Keyword(s):  
Risk Factors ◽  
Ph Value ◽  
Gastric Perforation ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Female Gender ◽  
Class Iii ◽  
Visceral Injury ◽  
Corrosive Injury ◽  
Preoperative Risk Factors

We reviewed 64 patients with perforation or full-thickness injury of the alimentary tract after acid ingestion. Based on our classification of laparotomy findings, there were class I (n=15); class II (n=13); class III (n=16); and class IV (n=20). Study parameters were preoperative laboratory data, gastric perforation, associated visceral injury, and extension of the injury. End points of the study were the patients’ mortality and length of hospital stay. All these patients underwent esophagogastrectomy with (n=16) or without (n=24) concomitant resection, esophagogastroduodenojejunectomy with (n=4) or without (n=13) concomitant resection, and laparotomy only (n=7). Concomitant resections were performed on the spleen (n=10), colon (n=2), pancreas (n=1), gall bladder (n=1), skipped areas of jejunum (n=4), and the first portion of the duodenum (n=4). The study demonstrates five preoperative risk factors, female gender, shock status, shock index, pH value, and base deficit, and four intraoperative risk factors, gastric perforation, associated visceral injury, injury beyond the pylorus, and continuous involvement of the jejunum over a length of 50 cm. The overall mortality rate was 45.3%, which increased significantly with advancing class of corrosive injury.

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