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Impact Of Age On Complications And Outcomes In Gender-affirming Surgery: An Analysis Of The National Surgical Quality Improvement Program Database
Hailey Paige Wyatt, BS, MD, Alexis K. Gursky, BS, Sachin R. Chinta, BS, Alay R. Shah, MD, Daniel J. Ceradini, MD, Eduardo D. Rodriguez, DDS, MD.
New York University Langone Health, New York, NY, USA.
PURPOSE:Gender-affirming surgery (GAS) plays a crucial role in alleviating gender dysphoria and enhancing the quality of life for transgender and non-binary individuals. Understanding peri-operative risk factors is imperative for this growing population. The aim of this study is to evaluate the effects of age on outcomes in gender-affirming surgery.
METHODS:The National Surgical Quality Improvement Program (NSQIP) Database was queried from 2018-2022 using current procedural terminology (CPT) codes specific to GAS. Patients were stratified by age into two groups, younger than and older than 50 years old. Multivariate logistic regression was used to analyze associations between age and surgical site infection (SSI), wound dehiscence (WD), reoperation and readmission. Linear regression was used to analyze associations between age and operating time (OP) and length of hospital stay (LOS).
RESULTS:Age over 50 had a significant association between feminine bottom surgery and SSI (OR = 5.09, CI 1.15-23.1), as well as a significant association between masculine bottom surgery and WD (OR = 10.19, CI 1.3-52.92), reoperation (OR = 9.01, CI 1.78-35.71), and readmission (OR = 6.44, CI 1.22-26.13). Both masculine and feminine bottom surgery were significantly associated with longer hospital stay in the age over 50 group.
CONCLUSION:Age significantly impacts the risk profile and outcomes in gender-affirming surgery. These findings highlight the need for tailored preoperative optimization and perioperative care to address the unique risks faced by older individuals undergoing gender-affirming surgery.
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