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Preexisting Depression or Anxiety is Associated with Increased Wound Complications Following Breast Reduction
Nir Zontag1,2, Ron Skorochod3,4, Yoram Wolf3,4
1Unit of Plastic and Reconstructive Surgery, Hillel Yaffe Medical Center, Hadera, Israel. nir.zontag@mail.huji.ac.il.
Background:
Breast reduction surgery is the primary treatment for macromastia, yet the impact of preexisting anxiety and depressive disorders (ADD) in candidates for this procedure has not been thoroughly investigated. This study aimed to evaluate the association between preexisting ADD and the incidence of both short-term and long-term complications after breast reduction surgery.
Methods:
This retrospective cohort study used data obtained from the TriNetX Global Collaborative Network to identify female patients over 18 years who had breast reduction. These patients were divided into two cohorts based on the presence or absence of ADD diagnosis. To reduce baseline differences and balance characteristics of the cohorts, we applied a propensity score matching. The primary objectives were short postoperative complications at 30, 60, and 90 days. Secondary objectives were long-term complications after 1 year.
Results:
Each cohort included 15,846 patients after 1:1 PSM analysis. Thirty days after surgery, patients with preexisting ADD were associated with significantly higher risks of seroma (Relative Risk [RR] 1.895, CI 1.43-2.5); hematoma (RR 1.508, CI 1.2-1.88); wound dehiscence (RR 1.33, CI 1.12-1.57); surgical site infection (RR 1.495, CI 1.24-1.79); postoperative opioid use (RR 1.291, CI 1.25-1.34); inpatient hospitalization (RR 1.77, CI 1.505-2.101); readmission (RR 1.857, CI 1.46-2.35); and any surgical site complications (RR 1.358, CI 1.23-1.50) compared to the control cohort. These findings persisted after 60 and 90 days of surgery. Comparable results were noted for long-term outcomes within 1 year of surgery.
Conclusion:
Patients with preexisting anxiety or depression disorders demonstrated higher rates of short-term postoperative outcomes after breast reduction procedure.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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