Analyzing Regional Differences over a 15-Year Trend of One-Stage versus Two-Stage Breast Reconstruction in 941,191 Postmastectomy Patients
| Autor: | Parisa Kamali, Bernard T. Lee, Marek A. Paul, Ahmed M.S. Ibrahim, Rieky E. Dikmans, Pieter G. L. Koolen, Marc L. Schermerhorn, Samuel J. Lin |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Breast Implants Mammaplasty medicine.medical_treatment Dentistry Breast Neoplasms 030230 surgery Logistic regression Surgical Flaps 03 medical and health sciences 0302 clinical medicine Breast cancer Humans Medicine Stage (cooking) Socioeconomic status Mastectomy Aged Neoplasm Staging Retrospective Studies business.industry Tissue Expansion Devices Retrospective cohort study Middle Aged medicine.disease Surgery 030220 oncology & carcinogenesis Female Implant business Breast reconstruction Follow-Up Studies Forecasting |
| Zdroj: | Plastic and Reconstructive Surgery. 138:1e-14e |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000002267 |
| Popis: | Implant-based reconstruction is the predominant form of breast reconstruction, with the two-stage tissue expander/implant approach being the most popular. Recently, the direct-to-implant, one-stage breast reconstruction procedure has gained momentum. In this study, national and regional trends across the United States for the two different types of implant-based reconstructions were evaluated. The Nationwide Inpatient Sample database was used to extrapolate data on type of mastectomy, implant-based reconstructive technique (one-stage or two-stage), and sociodemographic and hospital variables. Differences were assessed using the chi-square test, impact of variables on reconstructive method was analyzed using logistic regression, and trends were analyzed using the Cochrane-Armitage test. Between 1998 and 2012, a total of 1,444,587 patients treated for breast cancer or at increased risk of breast cancer met the defined selection criteria. Of these, 194,377 patients underwent implant-based breast reconstruction (13.6 percent one-stage and 86.4 percent two-stage). In both, there was a significant increase in procedures performed over time (p < 0.001). The highest increase in both was seen in the Northeast region of the United States, and the lowest increase was seen in the South. When stratified into regions, analysis showed differences in socioeconomic and hospital characteristics within the different regions. There is an observed increase in the number of one-stage and two-stage breast reconstructions being performed. Sociodemographic and hospital factors of influence vary in the different regions of the United States. This study provides important information for clinicians and policy makers who seek to ensure equitable and appropriate access for patient to the different types of implant-based procedures. |
| Databáze: | OpenAIRE |
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