Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety
Background:. Immediate alloplastic breast reconstruction was traditionally performed as an inpatient procedure. Despite several reports in the literature demonstrating comparable safety outcomes, there remains hesitancy to accept breast reconstruction performed as an outpatient procedure. Methods:....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2023-09-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005135 |
| _version_ | 1797671832373952512 |
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| author | Andrea K. Little, MD, MBA Darin L. Patmon, BA Harminder Sandhu, BS Shannon Armstrong, MD, MBA Daniella Anderson, MD Megan Sommers, MD |
| author_facet | Andrea K. Little, MD, MBA Darin L. Patmon, BA Harminder Sandhu, BS Shannon Armstrong, MD, MBA Daniella Anderson, MD Megan Sommers, MD |
| author_sort | Andrea K. Little, MD, MBA |
| collection | DOAJ |
| description | Background:. Immediate alloplastic breast reconstruction was traditionally performed as an inpatient procedure. Despite several reports in the literature demonstrating comparable safety outcomes, there remains hesitancy to accept breast reconstruction performed as an outpatient procedure.
Methods:. A retrospective review of National Surgical Quality Improvement Program data from 2014 to 2018 was utilized to evaluate recent trends and 30-day postoperative complication rates for inpatient versus outpatient immediate prosthetic-based breast reconstruction. Propensity score matching was used to obtain comparable groups.
Results:. During the study period, 33,587 patients underwent immediate alloplastic breast reconstruction. Of those, 67.5% of patients were discharged within 24 hours, and 32.4% of patients had a hospital stay of more than 24 hours. Immediate alloplastic reconstruction had an overall growth rate of 16.9% from 2014 to 2018. After propensity score matching, intraoperative variables that correlated with significantly increased inpatient status included increased work relative value units (16.3 ± 2.3 versus 16.2 ± 2.6; P < 0.001), longer operative times (228 ± 86 versus 206 ± 77; P < 0.001), and bilateral procedure (44.0% versus 43.5%; P < 0.001). There were higher rates of pulmonary embolism, wound dehiscence, urinary tract infection, transfusions, sepsis, readmissions, and reoperations in the group with the longer hospital stay.
Conclusion:. Based on increased complication rates and costs in the inpatient setting, we propose outpatient reconstructive surgery as a safe and cost-effective alternative for immediate alloplastic breast reconstruction. |
| first_indexed | 2024-03-11T21:21:13Z |
| format | Article |
| id | doaj.art-b4e4bd4dc79f4c1696d06753428d5fab |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-11T21:21:13Z |
| publishDate | 2023-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-b4e4bd4dc79f4c1696d06753428d5fab2023-09-28T07:09:03ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-09-01119e513510.1097/GOX.0000000000005135202309000-00052Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and SafetyAndrea K. Little, MD, MBA0Darin L. Patmon, BA1Harminder Sandhu, BS2Shannon Armstrong, MD, MBA3Daniella Anderson, MD4Megan Sommers, MD5From the * Division of Plastic and Reconstructive Surgery, Spectrum Health Michigan State University Plastic Surgery Residency, Grand Rapids, Mich.† Michigan State University College of Human Medicine, Grand Rapids, Mich.† Michigan State University College of Human Medicine, Grand Rapids, Mich.‡ Elite Plastic Surgery, Grand Rapids, Mich.From the * Division of Plastic and Reconstructive Surgery, Spectrum Health Michigan State University Plastic Surgery Residency, Grand Rapids, Mich.From the * Division of Plastic and Reconstructive Surgery, Spectrum Health Michigan State University Plastic Surgery Residency, Grand Rapids, Mich.Background:. Immediate alloplastic breast reconstruction was traditionally performed as an inpatient procedure. Despite several reports in the literature demonstrating comparable safety outcomes, there remains hesitancy to accept breast reconstruction performed as an outpatient procedure. Methods:. A retrospective review of National Surgical Quality Improvement Program data from 2014 to 2018 was utilized to evaluate recent trends and 30-day postoperative complication rates for inpatient versus outpatient immediate prosthetic-based breast reconstruction. Propensity score matching was used to obtain comparable groups. Results:. During the study period, 33,587 patients underwent immediate alloplastic breast reconstruction. Of those, 67.5% of patients were discharged within 24 hours, and 32.4% of patients had a hospital stay of more than 24 hours. Immediate alloplastic reconstruction had an overall growth rate of 16.9% from 2014 to 2018. After propensity score matching, intraoperative variables that correlated with significantly increased inpatient status included increased work relative value units (16.3 ± 2.3 versus 16.2 ± 2.6; P < 0.001), longer operative times (228 ± 86 versus 206 ± 77; P < 0.001), and bilateral procedure (44.0% versus 43.5%; P < 0.001). There were higher rates of pulmonary embolism, wound dehiscence, urinary tract infection, transfusions, sepsis, readmissions, and reoperations in the group with the longer hospital stay. Conclusion:. Based on increased complication rates and costs in the inpatient setting, we propose outpatient reconstructive surgery as a safe and cost-effective alternative for immediate alloplastic breast reconstruction.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005135 |
| spellingShingle | Andrea K. Little, MD, MBA Darin L. Patmon, BA Harminder Sandhu, BS Shannon Armstrong, MD, MBA Daniella Anderson, MD Megan Sommers, MD Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety Plastic and Reconstructive Surgery, Global Open |
| title | Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety |
| title_full | Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety |
| title_fullStr | Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety |
| title_full_unstemmed | Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety |
| title_short | Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety |
| title_sort | inpatient versus outpatient immediate alloplastic breast reconstruction recent trends outcomes and safety |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005135 |
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