Some general thoughts
In evaluating risk, people should consider a variety of different issues. Some of them are the same issues that anyone considering a surgery that is not an emergency surgery (an elective surgery) should be considering. In researching surgical outcomes, there is a whole literature about problems related to hospitalization.
Hospital Acquired Infections
A study was released this year in the New England Journal of Medicine that talks about prevalence of hospital acquired infections. They looked at 183 hospitals and 11,292 patients. MaGill, S. et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014; 370:1198-1208March 27, 2014DOI: 10.1056/NEJMoa1306801 http://www.nejm.org/doi/full/10.1056/NEJMoa1306801.
1 out of 25 people will get a hospital acquired infection. These are called HAIs or health care acquired infections or nosocomial infections. About half of these occur in intensive care. There were about 722,000 HAI’s reported in 2011 and 75,000 people with and HAI died while hospitalized. That does not mean they died from their HAI. Simply that when they died they had an HAI.
What kinds of Infections?
Pneumonia (21.8%) and surgical site infections (21.8%), gastrointestinal infections (17.1%), urinary tract infections, and blood stream infections make up the largest number of HAI. Devices such as central lines, catheters, intubation, etc. accounted for 25% of the infections. The major biological culprit was Clostridium difficile AKA C difficile.
Any surgery involves risk.
These include: infections, as stated above, bad reactions to medications including allergies, blood clots, necrosis, scarring, nerve damage, short term pain, and the development of chronic pain.
Plastic surgery can not guarantee outcomes. Disappointment is a big risk. Realistic expectations are important. Often people have results or scarring they did not expect. Sometimes that is the responsibility of the person having the surgery for not following the surgeons’ directives. People who do not follow directives or withhold information from surgeon’s are risking bad outcomes. For instance, people who think the requirement to stop smoking is simply a moral issues rather than a surgical outcome issue and resume smoking as soon as possible will likely reget that decision.
Medication interactions. This is very important for people on psychiatric medication. There are pain killers that can interact with SSRI’s and SNRI’s and cause serotonin syndrome. Make sure your surgeon knows what medications you are taking.
Look into your hospital. As an informed consumer, it’s worth researching your hospital and not just your surgeon.
Hospital Compare http://www.medicare.gov/hospitalcompare/search.html?AspxAutoDetectCookieSupport=1
US News and World Report ranks hospitals. They do this for colleges too and people argue about the validity of these sorts of rankings. http://health.usnews.com/best-hospitals/rankings
Death related to poor hospital care.
People in hospitals make mistakes. The IOM says it’s about 98,000 people a year but a newer study suggests that hospital care is the third leading cause of death in the US.
That study estimate harm from patient care in the hospital and came out last year. That study was conducted by someone who lost their child and attributed that death to negligence. It’s worth reading and assessing for yourself. James, JT. A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care Journal of Patient Safety: September 2013 – Volume 9 – Issue 3 – p 122–128
How Many Die From Medical Mistakes in U.S. Hospitals? http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals
You have to do what you can to reduce the chances or bad outcomes and to keep yourself safe.
Patient Safety: What You Can Do to Be a Safe Patient http://www.cdc.gov/HAI/patientSafety/patient-safety.html