Keith R Sweitzer, David Milek, Joseph M Escandón, Derrick Sanderson, Jose G Christiano
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引用次数: 0
Abstract
Background: Ad hoc and patient-reported outcome measures not specific to transgender surgery limit assessment of the impact of gender-affirming procedures. Patient-Reported Outcomes Measurement Information System (PROMIS) was developed as an objective and validated instrument to measure patient-related outcomes. In our study, we aimed to describe and analyze mean T-score changes in PROMIS before and after gender-affirming mastectomy.
Methods: A single-institution retrospective review of a prospectively maintained database was conducted on patients undergoing gender-affirming mastectomy (GAM) between October 2016 and July 2023. Along with demographic data, PROMIS T-scores for different health domains related to gender dysphoria were collected preoperatively and at postoperative months 1, 3, and 6. Tukey-Kramer adjustment statistical analysis and linear mixed-effect model were employed to accommodate both fixed and random effects from nonindependence in the data with adjusted P < 0.05 being considered statistically significant.
Results: A total of 185 patients were included. The average age was 23.7 years. Seven percent of patients were identified as nonbinary; 91% received preoperative hormonal therapy. Furthermore, 87.7% completed the survey on postoperative month 1 (POM1), 68.3% on POM3, and 47.5% on POM6. Baseline anxiety was found significantly worse (T-score, 60.4) compared to general US population. Satisfaction with social roles, anxiety, depression, social isolation, and anger demonstrated significantly improved T-scores after GAM on POM1, 3, and 6 compared to preoperative values.
Conclusions: Female-to-male transgender patients undergoing GAM demonstrated lasting improvements in satisfaction with social roles, anxiety, depression, social isolation, and anger over the period of 6 months postoperatively. PROMIS represents a relevant and useful tool to measure patient-reported outcomes in patients undergoing gender-affirming surgery.
期刊介绍：
The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.
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