Serotonergic Antidepressants and Postoperative Hematoma Risk After Abdominoplasty: A Study Using Propensity Score Matching.

Background: The incidence of psychiatric disorders, particularly major depressive disorder, is increasingly observed among patients undergoing plastic surgery procedures. This trend has raised concerns about the impact of serotonergic antidepressants on postoperative complications, especially the incidence of hematomas.

Objectives: To investigate the risk of developing postoperative hematoma after abdominoplasty in patients who did or did not use serotonergic antidepressants prior to surgery.

Methods: Data from TriNetX (TriNetX, LLC, Cambridge, MA) was used to identify female patients who underwent abdominoplasty. Patients were classified in two cohorts: the exposure cohort included patients with serotonergic antidepressants use, while the control cohort included patients who did not use these medications. Propensity score-matching analyses were performed to adjust for bleeding risk factors. Hematoma diagnosis was used as the primary outcome, while other outcomes included seroma, wound dehiscence, surgical site infection, blood transfusion, and hematoma/seroma evacuation. All outcomes were assessed at 7, 15, and 30 days following surgery.

Results: After matching for the 7-day outcomes analysis, each group contained 5,882 individuals. Patients who used serotonergic antidepressants had a significantly increased risk of hematoma (risk ratio [RR] 1.95, p<0.001), transfusion (RR 1.57, p=0.007), and hematoma/seroma evacuation (RR 1.65, p=0.004) within 7 days post-surgery. Similar results were observed at 15 and 30 days after surgery.

Conclusions: Patients who used serotonergic antidepressants prior to surgery had an increased risk of hematoma and other related complications after abdominoplasty. These findings underscore the need for preoperative counseling and risk assessment in this population.