Reoperation for Complications after Lumpectomy and Mastectomy for Breast Cancer from the 2012 National Surgical Quality Improvement Program (ACS-NSQIP)

Zahraa Al-Hilli, Kristine M. Thomsen, Elizabeth B Habermann, James W Jakub, Judy C Boughey

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Hospital readmissions and reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned reoperations within 30 days of initial procedure. The main objective of this study was to identify reoperation rates as a result of complications and evaluate complications by type of breast surgery. Methods: Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All reoperations and complication-related reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests. Results: Of 18,500 patients, 781 (4 %) required an unplanned reoperation within 30 days (single reoperation in 747, 2+ reoperations in 34). Mean time to first reoperation was 13.4 days and varied by procedure. A majority (73 %) of ACS-NSQIP coded unplanned reoperations were due to complications. Rates of reoperation due to complication were highest in mastectomy with IBR (7 %). Most common complications requiring reoperation were bleeding, followed by infection and wound-related problems. Conclusions: Unplanned reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring reoperation.

Original languageEnglish (US)
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - Jul 25 2015

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Segmental Mastectomy
Mastectomy
Quality Improvement
Reoperation
Breast Neoplasms
Mammaplasty
Breast
Hemorrhage
Patient Readmission
Wound Infection
Chi-Square Distribution
Patient Care

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

@article{fa44614352d1447c9f83d1d07afb284c,
title = "Reoperation for Complications after Lumpectomy and Mastectomy for Breast Cancer from the 2012 National Surgical Quality Improvement Program (ACS-NSQIP)",
abstract = "Background: Hospital readmissions and reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned reoperations within 30 days of initial procedure. The main objective of this study was to identify reoperation rates as a result of complications and evaluate complications by type of breast surgery. Methods: Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All reoperations and complication-related reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests. Results: Of 18,500 patients, 781 (4 {\%}) required an unplanned reoperation within 30 days (single reoperation in 747, 2+ reoperations in 34). Mean time to first reoperation was 13.4 days and varied by procedure. A majority (73 {\%}) of ACS-NSQIP coded unplanned reoperations were due to complications. Rates of reoperation due to complication were highest in mastectomy with IBR (7 {\%}). Most common complications requiring reoperation were bleeding, followed by infection and wound-related problems. Conclusions: Unplanned reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring reoperation.",
author = "Zahraa Al-Hilli and Thomsen, {Kristine M.} and Habermann, {Elizabeth B} and Jakub, {James W} and Boughey, {Judy C}",
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language = "English (US)",
journal = "Annals of Surgical Oncology",
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T1 - Reoperation for Complications after Lumpectomy and Mastectomy for Breast Cancer from the 2012 National Surgical Quality Improvement Program (ACS-NSQIP)

AU - Al-Hilli, Zahraa

AU - Thomsen, Kristine M.

AU - Habermann, Elizabeth B

AU - Jakub, James W

AU - Boughey, Judy C

PY - 2015/7/25

Y1 - 2015/7/25

N2 - Background: Hospital readmissions and reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned reoperations within 30 days of initial procedure. The main objective of this study was to identify reoperation rates as a result of complications and evaluate complications by type of breast surgery. Methods: Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All reoperations and complication-related reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests. Results: Of 18,500 patients, 781 (4 %) required an unplanned reoperation within 30 days (single reoperation in 747, 2+ reoperations in 34). Mean time to first reoperation was 13.4 days and varied by procedure. A majority (73 %) of ACS-NSQIP coded unplanned reoperations were due to complications. Rates of reoperation due to complication were highest in mastectomy with IBR (7 %). Most common complications requiring reoperation were bleeding, followed by infection and wound-related problems. Conclusions: Unplanned reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring reoperation.

AB - Background: Hospital readmissions and reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned reoperations within 30 days of initial procedure. The main objective of this study was to identify reoperation rates as a result of complications and evaluate complications by type of breast surgery. Methods: Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All reoperations and complication-related reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests. Results: Of 18,500 patients, 781 (4 %) required an unplanned reoperation within 30 days (single reoperation in 747, 2+ reoperations in 34). Mean time to first reoperation was 13.4 days and varied by procedure. A majority (73 %) of ACS-NSQIP coded unplanned reoperations were due to complications. Rates of reoperation due to complication were highest in mastectomy with IBR (7 %). Most common complications requiring reoperation were bleeding, followed by infection and wound-related problems. Conclusions: Unplanned reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring reoperation.

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