National Estimates Of Gender-Affirming Surgery In The U.S.
Trends in inpatient and outpatient gender-affirming surgery (GAS) procedures in the U.S. and in the types of GAS performed across age groups are of interest. As reported on August 23, 2023 in JAMA Network Open, a total of 48,019 patients who underwent GAS were identified, including 25,099 (52.3%) who were aged 19 to 30 years. The most common procedures involved the breast and chest, which occurred in 27,187 patients (56.6%), followed by genital reconstruction (16,872 [35.1%]) and other facial and cosmetic procedures (6,669 [13.9%]). The absolute number of GAS procedures rose from 4,552 in 2016 to a peak of 13,011 in 2019 and then declined slightly to 12,818 in 2020. Overall, 25,099 patients (52.3%) were aged 19 to 30 years, 10,476 (21.8%) were aged 31 to 40, and 3,678 (7.7%) were aged 12 to 18 years. When stratified by the type of procedure performed, breast and chest procedures made up a greater percentage of the surgical interventions in younger patients, while genital surgical procedures were greater in older patients.
Nonfatal And Fatal Falls Among Adults Aged ≥65 Years—United States, 2020–2021
Unintentional falls in the U.S. are the leading cause of injury and injury death among adults aged ≥65 years (older adults). Patterns of nonfatal and fatal falls differ by sex and state. According to the September 1, 2023 issue of Morbidity And Mortality Weekly Report, data from the 2020 Behavioral Risk Factor Surveillance System and 2021 National Vital Statistics System were used to ascertain the percentage of older adults who reported falling during the previous year and unintentional fall-related death rates among older adults. In 2020, 14 million (27.6%) older adults reported falling during the previous year. The percentage of women who reported falling (28.9%) was higher than that among men (26.1%). The percentage of older adults who reported falling ranged from 19.9% (Illinois) to 38.0% (Alaska). In 2021, 38,742 (78.0 per 100,000 population) older adults died as the result of unintentional falls. The fall–related death rate ranged from 30.7 per 100,000 population in Alabama to 176.5 in Wisconsin.
HEALTH TECHNOLOGY CORNER
Exercise Test Predicts Both Noncardiovascular And Cardiovascular Death
The treadmill exercise test with electrocardiogram (ECG) typically focuses on diagnosing coronary artery disease. A study from the Mayo Clinic described in the September 2023 issue of the journal Mayo Clinic Proceedings finds that exercise test abnormalities, such as low functional aerobic capacity, predicted non-cardiovascular causes of death such as cancer in addition to cardiovascular-related deaths. The investigation looked at 13,382 patients who had no baseline cardiovascular issues or other serious diseases and who had completed exercise tests at the Mayo Clinic between 1993 and 2010, then were followed closely for a median period of 12.7 years. The principal new finding is that noncardiovascular (CV) deaths predominate in a primary prevention cohort in absence of significant baseline CV disease. The findings suggest that clinicians should focus not only on ECG results, but on data in the exercise test results, such as low functional aerobic capacity, low chronotropic index, and abnormal heart rate recovery.
Menopause—Biology, Consequences, Supportive Care, And Therapeutic Options
A review published on September 6, 2023 in the journal Cell summarizes the biology and consequences of menopause, the role of supportive care, and the menopause-specific therapeutic options available to women. Optimizing health at menopause is the gateway to healthy aging for women. Although not all women will experience bothersome menopause-related symptoms, the silent effects of the menopause transition may be substantial, such as bone loss increasing future fragility fracture risk and adverse effects on blood lipids and cardiometabolic disease risk. Thus, all women should have access to a general health assessment at the time of menopause transition to maximize their physical well-being, including their cardiometabolic and musculoskeletal health, and their psychological and sexual well-being. Women with bothersome menopausal symptoms should be counseled on treatment options and offered evidence-based therapies, such as menopausal hormone therapy (MHT).