Evidence map›Paper›PMID 37864119›Full record

ArticleAnnals of surgical oncology2024

Frail but Resilient: Frailty in Autologous Breast Reconstruction is Associated with Worse Surgical Outcomes but Equivalent Long-Term Patient-Reported Outcomes.

Abbas M Hassan, Praneet Paidisetty, Nicholas Ray, Janhavi G Govande, Jonas A Nelson, Babak J Mehrara, Charles E Butler, Alexander F Mericli, Jesse C Selber

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Abbas M HassanDivision of Plastic and Reconstructive Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Praneet PaidisettyMcGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Nicholas RayMcGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Janhavi G GovandeMcGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Jonas A NelsonDepartment of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Babak J MehraraDepartment of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Charles E ButlerDepartment of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Alexander F MericliDepartment of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. AFMericli@mdanderson.org.
Jesse C SelberCorewell Health, Grand Rapids, MI, USA.
The University of Texas Health Science Center at Houston · USMemorial Sloan Kettering Cancer Center · USThe University of Texas MD Anderson Cancer Center · USCorewell HealthIndiana University School of Medicine

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFrailty is associated with higher risk of complications following breast reconstruction, but its impact on long-term surgical and patient-reported outcomes has not been investigated. We examined the association of the five-item modified frailty index (MFI) score with long-term surgical and patient-reported outcomes in autologous breast reconstruction. PATIENTS AND

methodsWe conducted a retrospective cohort study of consecutive patients who underwent mastectomy and autologous breast reconstruction between January 2016 and April 2022. Primary outcome was any flap-related complication. Secondary outcomes were patient-reported outcomes and predictors of complications in the frail cohort.

resultsWe identified 1640 reconstructions (mean follow-up 24.2 ± 19.2 months). In patients with MFI ≥ 2, the odds of surgical [odds ratio (OR) 2.13, p = 0.023] and medical (OR 17.02, p < 0.001) complications were higher than in nonfrail patients. We found no significant difference in satisfaction with the breast (p = 0.287), psychosocial well-being (p = 0.119), or sexual well-being (p = 0.314) according to MFI score. Chronic obstructive pulmonary disease was an independent predictor of infection (OR 3.70, p = 0.002). Tobacco use (OR 7.13, p = 0.002) and contralateral prophylactic mastectomy (OR 2.36, p = 0.014) were independent predictors of wound dehiscence. Dependent functional status (OR 2.36, p = 0.007) and immediate reconstruction (compared with delayed reconstruction; OR 3.16, p = 0.026) were independent predictors of skin flap necrosis. Dependent functional status was also independently associated with higher odds of reoperation (OR 2.64, p = 0.011).

conclusionFrailty is associated with higher risk of complications in breast reconstruction, but there is no significant difference in long-term patient-reported outcomes. MFI should be considered in breast reconstruction to improve outcomes in high-risk frail patients.

Indexed as

Breast NeoplasmsFrailtyMammaplastyAgedFemaleFrail ElderlyHumansMastectomyPatient Reported Outcome MeasuresPostoperative ComplicationsRetrospective StudiesTreatment Outcome

Identifiers

PMID37864119
OpenAlexW4387804951

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.