Erin Cordeiro1, Toni Zhong2, Timothy Jackson3, Tulin Cil4. 1. Division of General Surgery, The Ottawa Hospital, Ottawa, ON, Canada. Electronic address: ecordeiro@toh.on.ca. 2. Division of Plastic and Reconstructive Surgery, University Health Network, Toronto, ON, Canada; Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada. 3. Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of General Surgery, University Health Network, Toronto, ON, Canada. 4. Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of General Surgery, University Health Network, Toronto, ON, Canada; Department of Surgery, Women's College Hospital, Toronto, ON, Canada.
Abstract
BACKGROUND: We sought to examine the safety of same-day breast reconstructive (BR) surgery. METHODS: An analysis of the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP) files was performed. Patients undergoing BR for breast cancer were examined, excluding those with high-risk co-morbidities or concurrent surgery. A propensity score was calculated and a multivariable logistic regression analysis was used to calculate the difference in 30-day complications between those undergoing SDS versus longer hospital stay. RESULTS: The study consisted of 21,539 patients; 17,449 had implant and 4090 had autologous breast reconstruction. 1195 (5.5%) underwent SDS, whereas 20,344 (94.5%) were admitted at least overnight. On unadjusted analysis, the rate of post-operative complications was nearly three times higher in those admitted compared to those undergoing SDS (6.7% vs. 2.5%; p < 0.001). On propensity score adjusted multivariable regression there was no significant difference in complications amongst those undergoing SDS versus staying in hospital (OR 1.4 (95%CI: 0.9, 2.2)). CONCLUSIONS: These results suggest that admitting BR patients does not prevent short-term complications and same day BR surgery is safe when co-morbidities are accounted for.
BACKGROUND: We sought to examine the safety of same-day breast reconstructive (BR) surgery. METHODS: An analysis of the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP) files was performed. Patients undergoing BR for breast cancer were examined, excluding those with high-risk co-morbidities or concurrent surgery. A propensity score was calculated and a multivariable logistic regression analysis was used to calculate the difference in 30-day complications between those undergoing SDS versus longer hospital stay. RESULTS: The study consisted of 21,539 patients; 17,449 had implant and 4090 had autologous breast reconstruction. 1195 (5.5%) underwent SDS, whereas 20,344 (94.5%) were admitted at least overnight. On unadjusted analysis, the rate of post-operative complications was nearly three times higher in those admitted compared to those undergoing SDS (6.7% vs. 2.5%; p < 0.001). On propensity score adjusted multivariable regression there was no significant difference in complications amongst those undergoing SDS versus staying in hospital (OR 1.4 (95%CI: 0.9, 2.2)). CONCLUSIONS: These results suggest that admitting BR patients does not prevent short-term complications and same day BR surgery is safe when co-morbidities are accounted for.
Authors: Michelle C Specht; Bridget N Kelly; Eleanor Tomczyk; Olivia A Ford; Alexandra J Webster; Barbara L Smith; Michelle A Gadd; Amy S Colwell; Eric C Liao Journal: Ann Surg Oncol Date: 2022-05-11 Impact factor: 4.339
Authors: Michelle Specht; Nikhil Sobti; Nikki Rosado; Eleanor Tomczyk; Olivia Abbate; Dan Ellis; Eric C Liao Journal: Breast Cancer Res Treat Date: 2020-06-19 Impact factor: 4.872