The Measurable Cost of Complications for Outpatient Cosmetic Surgery in Patients With Mental Health Diagnoses

Wimalawansa, Sunishka M.; Fox, Justin P.; Johnson, R Michael

doi:10.1177/1090820x13519100

Cited by 16 publications

(10 citation statements)

References 31 publications

(21 reference statements)

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“…Serious mental illness was diagnosed with an objective measure (eg, ICD diagnosis codes) or by a psychiatrist in 19 studies; in seven studies, it was determined with a validated patient self-report instrument. The investigated diagnoses were any serious mental illness, 17,19,[24][25][26]28,30,31,34,41,42 depression, 17,18,[20][21][22]25,32,33,[35][36][37]39,40 anxiety, 17,23,32,35,38,39,41 schizophrenia, 22,25,27,29,31,32 bipolar disorder, 17,22 and PTSD 17,22 (Supporting Information, table 2).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Overall risk of bias was low in eighteen studies. 17,[20][21][22][24][25][26][29][30][31][32][33][36][37][38][40][41][42] Five studies were assessed as having a moderate risk of bias because of problems with study participation, outcome measurements, confounding, or poor statistical analysis. 18,19,23,28,35 Three studies were assessed as having a high risk of overall bias because of problems with study attrition, prognostic measures, confounding, or statistical analysis.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…18,19,23,28,35 Three studies were assessed as having a high risk of overall bias because of problems with study attrition, prognostic measures, confounding, or statistical analysis. 27,34,39 Risk of study confounding was low in 20 studies that measured and adjusted for key confounders, such as age, sex, ethnic background, and comorbid medical conditions that can affect surgical outcomes 17,18,[20][21][22][24][25][26][28][29][30][31][32][33][36][37][38][40][41][42] (Supporting Information, table 3).…”

Section: Risk Of Biasmentioning

confidence: 99%

“…The pooled results of five studies that investigated the association between any serious mental illness and hospital readmission within 30 days of discharge 18,22,28,30,42 indicated that patients with any serious mental illness were almost twice as likely to be re-admitted to hospital within 30 days as other patients (OR, 1.91; 95% CI, 1.17-3.10); the difference for patients with depression was not statistically significant 18,22 (Supporting Information, figure 6).…”

Section: Hospital Re-admissionmentioning

confidence: 99%

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Surgical outcomes for people with serious mental illness are poorer than for other patients: a systematic review and meta‐analysis

McBride

Solomon

Bannon

et al. 2021

Medical Journal of Australia

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atients with serious mental illness who require surgical care are routinely treated in non-psychiatric hospitals. 1 As the prevalence of serious mental illness is relatively low (2-3% in Australia 2 ), it is unsurprising that surgeons only infrequently ask patients about their mental health before operations, and lack confidence in caring for these vulnerable and complex patients. 3 Serious mental illness should be treated like any other medical comorbidity and managed pro-actively, both before and after surgery, to optimise the patient's care. This ideal is realised for some surgery types, such as solid organ transplantation and bariatric surgery, 4,5 but established care pathways for patients undergoing routine surgical treatment are rare. Further, patients with serious mental illnesses have a higher burden of chronic disease, 6 experience negative attitudes from a range of health professionals, 7-11 and may find navigating complex health systems difficult. 12,13 Several studies have investigated surgical outcomes for people with serious mental illness, but there have been few reviews; findings with regard to relative mortality and morbidity have been mixed, and the overall risk for these vulnerable patients is unclear. The aim of our systematic review and meta-analysis was to develop a greater understanding of the association between having a serious mental illness and outcomes of elective surgery for adults, including in-hospital and 30-day mortality, hospital re-admission, post-operative complications, and hospital length of stay. MethodsWe employed the methods recommended by the Cochrane Methods Prognosis Group 14 and our review protocol concords with the PRISMA-P statement 15 (PROSPERO registration, CRD42018080114; 30 January 2018).

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Risk Of Biasmentioning

confidence: 99%

Section: Risk Of Biasmentioning

confidence: 99%

Section: Hospital Re-admissionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical outcomes for people with serious mental illness are poorer than for other patients: a systematic review and meta‐analysis

McBride

Solomon

Bannon

et al. 2021

Medical Journal of Australia

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“…The current literature recognizes the effect of active mental illness on surgical outcomes, reporting that mental illness is associated with higher rates of postoperative morbidity, additional operations, and financial burden [19,20]. At the time of the initial visit, the patient was regularly visiting a clinical psychologist and was cleared for surgery from a mental health perspective.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Facial Port-Wine Stain in Sturge Weber Syndrome

Ainuz

Wolfe

2021

Cureus

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Sturge Weber Syndrome is characterized by the classic triad of a facial port-wine stain, leptomeningeal angiomatosis, and glaucoma. The resultant facial vascular anomaly can lead to soft tissue and bone irregularities, causing psychosocial distress and mental health morbidity. When severe, patients can opt for multi-staged surgical intervention by reconstructive surgeons to restore normal symmetry and improve the aesthetic appearance of the face. This study reports a case of surgical correction for severe facial vascular malformation resulting in poor outcomes due to the associated mental comorbidities seen in Sturge Weber Syndrome. A 37-year-old male with previously diagnosed Sturge Weber Syndrome presented to the outpatient craniofacial clinic for surgical evaluation of a large facial tuberous hemangioma. The patient underwent multiple operations for facial reconstruction including a staged full-thickness skin graft, facial recontouring, and extracranial correction of vertical orbital dystopia. The case was complicated by the patient’s poorly controlled seizure disorder and psychosocial illness, resulting in self-mutilation of the repair and poor follow-up. Over the span of 10 years, the patient’s mental illness caused him to fail numerous attempts at facial restoration and ultimately led to a poor final result. The psychosocial distress seen in patients with Sturge Weber Syndrome can adversely affect surgical outcomes. Physicians should be mindful of the possible complications that can arise in these patients and have the clinical means to address them.

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Enhanced Recovery After Surgery (ERAS) Pathways for Aesthetic Breast Surgery: A Prospective Cohort Study on Patient-Reported Outcomes

Stahl¹,

Stahl²,

Feng

et al. 2023

Aesth Plast Surg

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Background Patients’ expectations of an anticipated timeline of recovery and fear of anesthesia in aesthetic breast surgery have not been studied. Objective This study aims to assess patient anxiety, expectations, and satisfaction after Enhanced Recovery after Surgery (ERAS) pathways for aesthetic breast surgery and the progress of postoperative recovery. Materials and methods All consecutive patients who underwent aesthetic breast surgery between April 2021 and August 2022 were included in this single-center prospective cohort study. The ERAS protocol consists of more than 20 individual measures in the pre-, intra-, and postoperative period. Epidemiological data, expectations, and recovery were systematically assessed with standardized self-assessment questionnaires, including the International Pain Outcome Questionnaire (IPO), the BREAST-Q or BODY-Q, and data collection forms. Results In total, 48 patients with a median of 30 years of age were included. Patients returned to most daily activities within 5 days. Eighty-eight percent of patients were able to accomplish daily activities sooner than expected. The time of return to normal daily activities was similar across all procedure types. There was no statistically significant difference regarding postoperative satisfaction between patients who recovered slower (12%) and patients who recovered as fast or faster (88%) than anticipated (p=0.180). Patients reporting fear of anesthesia in the form of conscious sedation significantly diminished from 17 to 4% postoperatively (p<0.001). Conclusion Enhanced Recovery after Surgery (ERAS) pathways for aesthetic breast surgery are associated with rapid recovery and high patient satisfaction. This survey study provides valuable insight into patients’ concerns and perspectives that may be implemented in patient education and consultations to improve patient satisfaction following aesthetic treatments. Level of Evidence IV 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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The Measurable Cost of Complications for Outpatient Cosmetic Surgery in Patients With Mental Health Diagnoses

Abstract: 4.

Cited by 16 publications

References 31 publications

Surgical outcomes for people with serious mental illness are poorer than for other patients: a systematic review and meta‐analysis

Surgical outcomes for people with serious mental illness are poorer than for other patients: a systematic review and meta‐analysis

Surgical Management of Facial Port-Wine Stain in Sturge Weber Syndrome

Enhanced Recovery After Surgery (ERAS) Pathways for Aesthetic Breast Surgery: A Prospective Cohort Study on Patient-Reported Outcomes

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