Risk Factors for Major Complications Identified for Patients Undergoing Breast Reduction: Analysis of 31,755 patients in the National Surgery Quality Improvement Program database

Abstract

Objective: Breast reductions remains one of the most common procedures performed by plastic surgeons annually in the United States. However, recent studies on risk factors leading to complications following this procedure on a national level have been limited. Our study aims to analyze the most recent national data collected and to compare it to previous similar studies. Methods: Our study analyzed retrospective data collected from the American College of Surgeons National Surgery Quality Improvement Program (NSQIP) database between the years 2015-2020. Those who underwent bilateral breast reductions were identified using the Current Procedural Terminology (CPT) code 19318 as their primary procedure. Those undergoing breast cancer related procedures were excluded. Descriptive statistics and chi square analysis were used to further analyze data. Major complications were defined as unplanned readmission or reoperation. Results: A total of 31,755 females were identified, all cancer related cases were excluded. Compared to previous studies, there was nearly double the total cases identified within the database over the last 5 years. Median age was 42.1, average BMI 30.8, and average operative time was 152 minutes. The overall major complication rate was 2.8%, similar to previous studies. Wound complication rate was 4.2%. Statistically significant factors of hypertension, bleeding disorder, diabetes, long-term steroid use, positive smoking status, high BMI and prolonged operative time were associated with increased risk of major complication. There was no significant difference in wound complication rate or major complication rates when stratified by specialty performing breast reductions. Conclusion: Well known risk factors for major complications that were previously identified using the NSQIP database continue to be demonstrated in recent data. These considerations should be taken into account on preoperative evaluation/discussions with patients undergoing breast reductions. Previously unexplored datapoints should be considered in future datasets such as marijuana use to further identify potential risks for complications. Corresponding Author: Ashraf Elzanie, MD, 200 Riverfront Dr. Apt 27C, Detroit, MI 48226