Preoperative use of serotonergic antidepressants is associated with increased rates of complications and surgical revision in autologous breast reconstruction

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2025-08-29 DOI:10.1016/j.bjps.2025.08.025

Matthew Q. Dao , Jacquelyn M. Roth , Bernice Z. Yu , Keisha E. Montalmant , Parul Rai , Arjun Nanda , Jasmin Wilson , Peter W. Henderson

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引用次数: 0

Abstract

Introduction

Depression and anxiety are common among women with breast cancer scheduled for autologous breast reconstruction, with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors serving as the first-line treatments. Although effective for mood disorders, perioperative use of these medications has been linked to impaired hemostasis and wound healing in recovering patients. We evaluated the association between preoperative serotonergic antidepressants and complications following reconstructive breast surgery.

Methods

Female patients were identified from the US collaborative network within TriNetX, a globally federated database. Adults (18 years and older) who underwent autologous breast reconstruction were stratified into 2 groups: those prescribed serotonergic antidepressants within 3 months preoperatively (n = 4434), and those without any documented use (n = 13,661). Propensity score matching controlled for demographics and comorbidities. Primary outcomes were postoperative complications within 90 days. Secondary outcomes included deformity of reconstructed breast and surgical revision at 1 and 2 years. Risk ratios (RR) were used to measure associations, with statistical significance set at p < 0.05.

Results

After matching, 3064 patients remained in each group. Patients who used serotonergic antidepressants before autologous breast reconstruction had significantly higher risks of developing complications, including sepsis (RR = 1.94, p = 0.004), seroma (RR = 1.58, p = 0.004), hematoma (RR = 1.29, p = 0.037), and surgical site infection (RR = 1.54, p < 0.0001), within 90 days. At 1 and 2 years, the rates of breast deformity and revision were also significantly elevated (p < 0.01).

Conclusion

Preoperative serotonergic antidepressant use is associated with increased short- and long-term complications following autologous breast surgery.

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术前使用5 -羟色胺类抗抑郁药与自体乳房重建并发症和手术翻修率增加有关。

导言：抑郁和焦虑在计划进行自体乳房重建的乳腺癌女性中很常见，选择性5 -羟色胺再摄取抑制剂和5 -羟色胺-去甲肾上腺素再摄取抑制剂是一线治疗。虽然这些药物对情绪障碍有效，但围手术期使用这些药物与恢复患者的止血和伤口愈合受损有关。我们评估术前5 -羟色胺能抗抑郁药与乳房重建手术并发症之间的关系。方法：从TriNetX（一个全球联合数据库）的美国合作网络中确定女性患者。接受自体乳房再造术的成人（18岁及以上）被分为两组：术前3个月内服用血清素能抗抑郁药的患者（n = 4434）和未使用任何记录的患者（n = 13661）。倾向评分匹配控制人口统计学和合并症。主要结局为90天内的术后并发症。次要结果包括1年和2年重建乳房畸形和手术翻修。采用风险比（RR）衡量相关性，差异有统计学意义，p < 0.05。结果：配对后，每组均保留3064例患者。自体乳房重建术前使用5 -羟色胺能抗抑郁药的患者在90天内发生并发症的风险明显更高，包括脓毒症（RR = 1.94, p = 0.004）、血肿（RR = 1.58, p = 0.004）、血肿（RR = 1.29, p = 0.037）和手术部位感染（RR = 1.54, p < 0.0001）。在1年和2年，乳房畸形和翻修率也显著升高（p < 0.01）。结论：术前使用血清素能抗抑郁药与自体乳房手术后短期和长期并发症的增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.