Dataset Information

The impact of the COVID-19 pandemic on alloplastic breast reconstruction: An analysis of national outcomes.

ABSTRACT:

Background

Immediate alloplastic breast reconstruction shifted to the outpatient setting during the COVID-19 pandemic to conserve inpatient hospital beds while providing timely oncologic care. We examine the National Surgical Quality Improvement Program (NSQIP) database for trends in and safety of outpatient breast reconstruction during the pandemic.

Methods

NSQIP data were filtered for immediate alloplastic breast reconstructions between April and December of 2019 (before-COVID) and 2020 (during-COVID); the proportion of outpatient procedures was compared. Thirty-day complications were compared for noninferiority between propensity-matched outpatients and inpatients utilizing a 1% risk difference margin.

Results

During COVID, immediate alloplastic breast reconstruction cases decreased (4083 vs. 4677) and were more frequently outpatient (31% vs. 10%, p < 0.001). Outpatients had lower rates of smoking (6.8% vs. 8.4%, p = 0.03) and obesity (26% vs. 33%, p < 0.001). Surgical complication rates of outpatient procedures were noninferior to propensity-matched inpatients (5.0% vs. 5.5%, p = 0.03 noninferiority). Reoperation rates were lower in propensity-matched outpatients (5.2% vs. 8.0%, p = 0.003).

Conclusion

Immediate alloplastic breast reconstruction shifted towards outpatient procedures during the COVID-19 pandemic with noninferior complication rates. Therefore, a paradigm shift towards outpatient reconstruction for certain patients may be safe. However, decreased reoperations in outpatients may represent undiagnosed complications and warrant further investigation.

SUBMITTER: Chiang SN

PROVIDER: S-EPMC9088498 | biostudies-literature |

REPOSITORIES: biostudies-literature

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