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Cross-Sectional Analysis of Patients Referred to a Tertiary Lymphatic Surgery Center
Zachary J Eisner1, Christine S W Best2, Jayna Lenders1
1University of Michigan Medical School, Ann Arbor, MI, USA.
Annals of Surgical Oncology
|October 9, 2024
Summary
Most patients referred for lymphedema surgery are not ideal candidates, highlighting a need for better referral education. Optimizing these referral patterns can improve access to effective lymphedema treatment.
Area of Science:
- Plastic Surgery
- Lymphedema Management
- Surgical Oncology
Background:
- Secondary lymphedema is a growing concern, increasing referrals to plastic surgery.
- Understanding patient referral patterns is key to improving lymphedema care.
- Optimizing the referral process can enhance patient access to surgical interventions.
Purpose of the Study:
- To analyze referral patterns for lymphedema patients.
- To identify characteristics of patients referred for lymphedema surgery.
- To evaluate the effectiveness of current referral sources and patient disposition.
Main Methods:
- Retrospective review of 285 patients referred for lymphedema surgery between 2016-2023.
- Analysis of patient demographics, clinical staging, referral sources, and prior treatments.
- Multivariate logistic regression to identify factors associated with lymphedema stage and surgical candidacy.
Main Results:
- 60% of referred patients had prior malignancy, and 45.6% had lymph node procedures.
- Factors like BMI, age, and prior therapy correlated with later lymphedema stages.
- Only 28.5% of referred patients proceeded to surgery; primary care and occupational therapy referrals were associated with higher surgical candidacy.
Conclusions:
- A significant portion of referred patients are not suitable for lymphedema surgery.
- Current referral patterns may not effectively identify appropriate surgical candidates.
- Multidisciplinary education is recommended to refine referral processes and improve access to lymphedema surgery.
