Unplanned reoperations after microsurgical breast reconstruction: Findings from the American College of Surgeons National Surgical Quality Improvement Program
| Autor: | Nathan G. Menon, Nathan T. Morrell, Barkat Ali, Venus Barlas, Eun Ho Eunice Choi |
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| Rok vydání: | 2021 |
| Předmět: |
Reoperation
medicine.medical_specialty medicine.medical_treatment Mammaplasty Breast Neoplasms Patient safety Postoperative Complications Risk Factors Medicine Humans Risk factor Mastectomy Retrospective Studies Surgeons business.industry General surgery Laboratory results Quality Improvement United States Acs nsqip Concomitant Current Procedural Terminology Surgery Female business Breast reconstruction |
| Zdroj: | MicrosurgeryREFERENCES. 42(2) |
| ISSN: | 1098-2752 |
| Popis: | While microsurgical breast reconstruction may require multiple planned operations, unplanned reoperations has not been studied. We sought to investigate unplanned reoperations after microsurgical breast reconstruction.We queried the American College of Surgeons' National Surgical Quality Improvement Program between 2005 and 2018. Current Procedural Terminology code 19364 was used to identify all patients with microsurgical breast reconstruction. Patient demographics, medical comorbidities, preoperative laboratory results, and operative data were analyzed. The primary outcome measure was 30-day unplanned reoperation.Of 8449 patients meeting inclusion criteria, 1021 required an unplanned reoperation (12.1%). These patients were more likely to be obese, smokers, hypertensive, on steroids preoperatively, needing concomitant mastectomy, and with prolonged operating room time9 h (p .05). Multivariable regression model revealed preoperative steroids intake (OR = 1.92, CI 1.09-3.38, p = .03), concomitant mastectomy (OR = 1.45, CI 1.23-1.71, p .01), and operating room time9 h (OR = 1.37, CI 1.16-1.62, p .01) as independent risk factors. Mastectomy was found to be an independent risk factor for early reoperation, that is, ≤2 days (OR = 1.44, CI 1.14-1.82, p .01), whereas obesity was an independent risk factor for three reoperations (OR = 3.92, CI 1.14-13.46, p = .03).Unplanned reoperations within 30-days after microsurgical breast reconstruction are a significant problem. Mastectomy is an independent risk factor for early reoperation whereas obesity is an independent risk factor for multiple reoperations. Identification of such patients preoperatively may help microsurgeons improve patient safety and quality of care. |
| Databáze: | OpenAIRE |
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