National Trends and In-Hospital Outcomes for Immediate Implant-Based Versus Autologous-Based Breast Reconstruction: A...

Area of Science:

• Plastic Surgery
• Surgical Outcomes Research
• Health Disparities

Background:

• Breast reconstruction utilizes autologous breast reconstruction (ABR) and implant-based breast reconstruction (IBR).
• Both ABR and IBR present distinct advantages and disadvantages.
• Understanding trends and complications is crucial for patient care.

Purpose of the Study:

• To analyze national trends in ABR versus IBR utilization from 2016 to 2020.
• To compare complication rates between ABR and IBR.
• To identify disparities in ABR use across patient and hospital subgroups.

Main Methods:

• Utilized the National Inpatient Sample (NIS) database (2016-2020).
• Employed International Classification of Diseases, 10th version (ICD-10) codes for patient cohort identification.
• Conducted a 1:1 propensity score-matched analysis to compare ABR and IBR groups.

Main Results:

• Breast reconstruction rates increased from 58.8% to 63.4% between 2016 and 2020.
• ABR utilization showed an upward trend, while IBR showed a downward trend.
• ABR was associated with higher rates of cardiovascular, respiratory, vascular, and bleeding complications, but lower rates of wound infection, dehiscence, seroma, and sepsis. Significant disparities in ABR use were observed based on age, teaching status, race, socioeconomic status, and hospital size.

Conclusions:

• The study observed an increasing trend in autologous breast reconstruction (ABR) and a decreasing trend in implant-based breast reconstruction (IBR).
• While ABR is linked to increased pulmonary, cardiovascular, vascular, and bleeding complications, it demonstrates a reduced incidence of wound-related complications.
• Significant disparities in ABR utilization exist across various demographic and hospital-related factors.