Characterizing differential risk effects of body mass index for Asian patients in the United States undergoing breast reconstruction

Dylan K Kim ¹, Christine H Rohde ¹

⁰Division of Plastic and Reconstructive Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Journal of Plastic, Reconstructive & Aesthetic Surgery : Jpras +

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March 30, 2024

View abstract on PubMed

Summary

Body mass index (BMI) impacts breast reconstruction outcomes differently in Asian versus White patients. Higher BMI percentile predicts complications in White patients, but not significantly in Asian patients, influencing risk assessments.

Area Of Science

Plastic Surgery
Reconstructive Surgery
Health Disparities

Background

Asian patient populations are underrepresented in plastic surgery research.
Understanding breast reconstruction outcomes in Asian women is crucial for patient counseling.
This study examines the role of body mass index (BMI) in breast reconstruction outcomes for Asian patients.

Purpose Of The Study

To investigate the differential effect of BMI on breast reconstruction outcomes in Asian versus White patients.
To determine if BMI is a significant predictor of postoperative complications in these distinct populations.
To inform risk stratification algorithms for breast reconstruction.

Main Methods

Utilized the National Surgical Quality Improvement Program database to identify Asian and White breast reconstruction patients.
Converted BMI to percentile ranks for standardized comparisons between cohorts.
Employed multivariate logistic regression to quantify the effects of BMI on complication occurrence.

Main Results

The study included 86,514 White and 4813 Asian patients.
Higher BMI percentile significantly predicted complications in White patients (OR: 1.005) but not in Asian patients (OR: 1.001).
BMI percentile predicted unplanned reoperation risk in both White and Asian patient cohorts.

Conclusions

The predictive value of BMI for complications in breast reconstruction is less consistent in Asian populations compared to White populations.
Findings suggest a need for nuanced interpretation of BMI in risk algorithms for diverse patient groups.
This research can guide more informed patient counseling regarding BMI and surgical outcomes.

Keywords:

Asian BMI Breast reconstruction Disparities Plastic surgery