58 posters, 14 topics, 4 sessions, 188 authors, 62 institutions
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PSRC 69th Annual Meeting 2024
May 16-19, 2024 | The Westin Copley Place, Boston, MA
EP03
Predictors Of Hospital Readmission After Autologous Vs Implant-based Breast Reconstruction: A 16 Year Analysis Of 175,474 Patients
Poster Presenter
Part of Topic
Breast
Title: Predictors of 30-day Hospital Readmission After Autologous vs. Implant-Based Breast Reconstruction: A 16-Year Analysis of 175,474 Patients
Authors: Isabella L. Lipkin BA, Renxi Li BS, Ava Daniel BS, Bharat G. Ranganath MD
Introduction
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Comorbidities that impair wound healing, increase infection risk, and compromise tissue viability influence rates of hospital readmission after autologous reconstruction (AR) and implant-based reconstruction (IBR).
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This study aimed to evaluate patient factors that increase risk for 30-day hospital readmission after AR and IBR.
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Our secondary aim was to identify differences in the comorbidities that affect readmission risk after IBR versus after AR.
Methods
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Patients from 2005 to 2021 were selected by AR and IBR current procedural terminology codes from the American College of Surgeons National Surgical Quality Improvement Program database.
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A multivariable regression model identified the significant predictors of unplanned readmission.
Results
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Comorbidities that increase risk for readmission after AR but not IBR include dialysis (OR=3.87; p=0.042) and malnutrition (OR=3.20; p=0.003).
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Risk factors for readmission after IBR but not AR include bleeding disorder (OR=2.62; p<0.0001), previous infection (OR=1.49; p=0.045), recent sepsis (OR=2.16; p=0.0003), anemia (OR=1.13, p=0.0018), and hypoalbuminemia (OR=1.35, p=0.0213).
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Predictors of unplanned readmission after both methods include chronic obstructive pulmonary disorder, obesity, inpatient status prior to procedure, Black or White race, chronic steroid use, smoking, diabetes, and hypertension.
Conclusions
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These findings may be used to guide preoperative discussions regarding optimization of risk factors.
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While AR and IBR are often combined into one category for discussion of factors that increase complication risk, our study suggests that they differ with regard to the comorbidities that increase risk for hospital readmission.