Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective Study
Background:. This multicenter, retrospective study compared clinical outcomes and healthcare resource use in patients who underwent dual-plane (DP) or prepectoral (PP) implant-based breast reconstruction (IBR) after mastectomy in the United States. Methods:. Medical records were selected for patient...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-03-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004845 |
| _version_ | 1797859617399635968 |
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| author | James R. Bruno, MD C. Coleman Brown, MD Allen Gabriel, MD Mousam Parikh, MS Kathryn P. Anastassopoulos, MS Kenneth R. Lee, MD Shoshana Daniel, PhD Rupali Naik, PhD Reema Patel, MPH Vaishali D. Patel, PharmD, MS |
| author_facet | James R. Bruno, MD C. Coleman Brown, MD Allen Gabriel, MD Mousam Parikh, MS Kathryn P. Anastassopoulos, MS Kenneth R. Lee, MD Shoshana Daniel, PhD Rupali Naik, PhD Reema Patel, MPH Vaishali D. Patel, PharmD, MS |
| author_sort | James R. Bruno, MD |
| collection | DOAJ |
| description | Background:. This multicenter, retrospective study compared clinical outcomes and healthcare resource use in patients who underwent dual-plane (DP) or prepectoral (PP) implant-based breast reconstruction (IBR) after mastectomy in the United States.
Methods:. Medical records were selected for patients at five sites undergoing immediate one-stage direct-to-implant (first hospitalization) or two-stage IBR (first and second hospitalization) using either DP or PP. Inverse probability of treatment weighting was used to adjust for potential confounders. Complications and healthcare resource use were assessed with logistic regression; pain severity was assessed with ordinary least-squares regression.
Results:. After inverse probability of treatment weighting, data from 255 patients (DP = 130, PP = 125) and 441 breasts (DP = 226, PP = 215) were analyzed. Mean pain severity scores were lower with PP versus DP immediately after IBR for first (P = 0.0002) and second hospitalizations (P = 0.0145), and before discharge for first (P < 0.0001) and second hospitalizations (P = 0.0002). A greater proportion of PP versus DP patients had a shorter hospital length of stay (≤ 23 hours) for first hospitalization (P = 0.0052); proportions were similar for second hospitalization (P = 0.5499). Intravenous narcotics were prescribed less frequently to PP versus DP patients during first (61.1% versus 69.8%, respectively; P = 0.1486) and second (37.5% versus 55.3%, respectively; P = 0.0172) hospitalizations. Complication rates were low in both groups after first hospitalization discharge (DP: 13.6%, PP: 12.5%, P = 0.7225).
Conclusion:. This retrospective study suggests that the PP technique in IBR may offer benefits related to clinical outcomes and health resource utilization; however, larger studies, including randomized controlled trials, are needed to confirm. |
| first_indexed | 2024-04-09T21:32:27Z |
| format | Article |
| id | doaj.art-538b304576ff41fe9a49c628562b1d2a |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-09T21:32:27Z |
| publishDate | 2023-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-538b304576ff41fe9a49c628562b1d2a2023-03-27T06:47:44ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-03-01113e484510.1097/GOX.0000000000004845202303000-00044Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective StudyJames R. Bruno, MD0C. Coleman Brown, MD1Allen Gabriel, MD2Mousam Parikh, MS3Kathryn P. Anastassopoulos, MS4Kenneth R. Lee, MD5Shoshana Daniel, PhD6Rupali Naik, PhD7Reema Patel, MPH8Vaishali D. Patel, PharmD, MS9From the * Bruno Brown Plastic Surgery, Chevy Chase, Md.From the * Bruno Brown Plastic Surgery, Chevy Chase, Md.† Plastic Surgery, Vancouver, Wa.‡ Allergan Aesthetics, an AbbVie Company, Madison, N.J.§ Market Access Consulting, Labcorp Drug Development, Gaithersburg, Md.¶ Orlando Health Aesthetic & Reconstructive Surgery Institute, Orlando, Fla.§ Market Access Consulting, Labcorp Drug Development, Gaithersburg, Md.‖ Noesis Healthcare Technologies, Inc., Redwood City, Ca.§ Market Access Consulting, Labcorp Drug Development, Gaithersburg, Md.‡ Allergan Aesthetics, an AbbVie Company, Madison, N.J.Background:. This multicenter, retrospective study compared clinical outcomes and healthcare resource use in patients who underwent dual-plane (DP) or prepectoral (PP) implant-based breast reconstruction (IBR) after mastectomy in the United States. Methods:. Medical records were selected for patients at five sites undergoing immediate one-stage direct-to-implant (first hospitalization) or two-stage IBR (first and second hospitalization) using either DP or PP. Inverse probability of treatment weighting was used to adjust for potential confounders. Complications and healthcare resource use were assessed with logistic regression; pain severity was assessed with ordinary least-squares regression. Results:. After inverse probability of treatment weighting, data from 255 patients (DP = 130, PP = 125) and 441 breasts (DP = 226, PP = 215) were analyzed. Mean pain severity scores were lower with PP versus DP immediately after IBR for first (P = 0.0002) and second hospitalizations (P = 0.0145), and before discharge for first (P < 0.0001) and second hospitalizations (P = 0.0002). A greater proportion of PP versus DP patients had a shorter hospital length of stay (≤ 23 hours) for first hospitalization (P = 0.0052); proportions were similar for second hospitalization (P = 0.5499). Intravenous narcotics were prescribed less frequently to PP versus DP patients during first (61.1% versus 69.8%, respectively; P = 0.1486) and second (37.5% versus 55.3%, respectively; P = 0.0172) hospitalizations. Complication rates were low in both groups after first hospitalization discharge (DP: 13.6%, PP: 12.5%, P = 0.7225). Conclusion:. This retrospective study suggests that the PP technique in IBR may offer benefits related to clinical outcomes and health resource utilization; however, larger studies, including randomized controlled trials, are needed to confirm.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004845 |
| spellingShingle | James R. Bruno, MD C. Coleman Brown, MD Allen Gabriel, MD Mousam Parikh, MS Kathryn P. Anastassopoulos, MS Kenneth R. Lee, MD Shoshana Daniel, PhD Rupali Naik, PhD Reema Patel, MPH Vaishali D. Patel, PharmD, MS Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective Study Plastic and Reconstructive Surgery, Global Open |
| title | Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective Study |
| title_full | Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective Study |
| title_fullStr | Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective Study |
| title_full_unstemmed | Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective Study |
| title_short | Clinical and Healthcare Resource Use Outcomes between Dual-plane and Prepectoral Techniques in Implant-based Breast Reconstruction: A Multicenter Retrospective Study |
| title_sort | clinical and healthcare resource use outcomes between dual plane and prepectoral techniques in implant based breast reconstruction a multicenter retrospective study |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004845 |
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