@Article{,
AUTHOR = {Rishabh K. Simhal, Kerith R. Wang, Caroline Purcell,
Yash B. Shah, Paul H. Chung},
TITLE = {Perioperative risk predictors for gender affirming surgery in the NSQIP database},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {31},
YEAR = {2024},
NUMBER = {2},
PAGES = {11826--11833},
URL = {http://www.techscience.com/CJU/v31n2/59596},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> Gender affirming surgeries (GAS), such
as phalloplasty (PLPs) and vaginoplasty (VGPs), are
important aspects of medical care for transgender patients.
Here, we aim to better characterize patient demographics
and surgical outcomes for PLPs and VGPs using the
National Surgical Quality Improvement Program
(NSQIP). We hypothesized that frailty indices would
be predictive of perioperative PLP and VGP risk and
outcomes for PLPs and VGPs.<br/>
<b>Materials and methods:</b> Primary GAS, specifically
PLPs and VGPs performed from 2006-2020 were
identified in NSQIP. Baseline frailty was based on
NSQIP’s modified frailty index (mFI) and preoperative
morbidity probability (morbprob) variable.<br/>
<b>Results:</b> Fifty-eight PLPs and 468 VGPs were
identified. The overall 30-day complication rate for PLP was 26%, with 17% of total patients experiencing
minor complications and 16% experiencing major
complications. The overall, minor, and major
complication rates for VGP were 14%, 7%, and 9%
respectively. Readmissions and reoperations occurred
in 7% PLP and 5% VGP patients. No deaths occurred
in either group within 30 days. The mFI scores were
not predictive of 30-day complications or LOS. NSQIP
morbprob was predictive of 30-day complications for both
PLP (OR 4.0, 95% CI 1.08-19.59, p = 0.038) and VGP
(OR 2.39, 95% CI 1.46-3.97, p = 0.0005). NSQIP’s
morbprob was also predictive of extended LOS for PLP
patients (6.3 ± 1.3 days, p = 0.03).<br/>
<b>Conclusions:</b> This study describes patient characteristics
and complication rates of PLPs and VGPs. The NSQIP
preoperative morbprob is an effective predictor of surgical
complications and is better than the mFI.},
DOI = {}
}