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Published on: April 28, 2022
Determining the Independent Risk Factors for Worse SCAR-Q Scores and Future Scar Revision Surgery
Natalia I Ziolkowski1, Ramy Behman1, Anne F Klassen1
1From the University of Toronto; McMaster University; Hospital for Sick Children, University of Toronto; Duke University School of Medicine; Auckland Regional Plastic Reconstructive and Hand Surgery; the Hospital de Urgencia Asistencia Publica; University of California Davis Health; and Harvard Brigham and Women's Hospital.
Patients perceiving their scars as bothersome or scarring badly face higher risks for poor appearance, symptoms, and psychosocial impact. This understanding aids in identifying individuals who may need future scar revision surgery.
Area of Science:
- Plastic surgery
- Dermatology
- Patient-reported outcome measures
Background:
- Increasing number of scar revisions necessitate better patient stratification.
- Patient-reported outcome measures (PROMs) are crucial for informed scar modulation decisions.
- Identifying risk factors for poor scar outcomes is essential for clinical management.
Purpose of the Study:
- Determine patient, scar, and clinical risk factors for low SCAR-Q scores (Appearance, Symptom, Psychosocial Impact).
- Investigate differences in risk factors for children.
- Identify predictors for the need for future scar revision surgery.
Main Methods:
- Multicenter international cross-sectional cohort study.
- Survey data from participants with traumatic, surgical, and burn scars.
- Univariate and multivariable logistic analyses to identify risk factors.
Main Results:
- A bothersome scar and perceiving scarring badly were independent risk factors for all SCAR-Q scales.
- Need for future surgery linked to health condition, scarring badly, scar diagnosis, prior revision, and low Psychosocial Impact scores.
- High model discrimination (C statistics 0.81-0.84).
Conclusions:
- First multicenter international study on risk factors for low PROMs and need for scar revision.
- Patients perceiving scarring badly and having bothersome scars are at higher risk for adverse outcomes.
- Findings aid in identifying patients for potential surgical intervention.
