J Reconstr Microsurg 2020; 36(08): 592-599
DOI: 10.1055/s-0040-1713174
Original Article

Racial Disparities in Outcomes of Reconstructive Breast Surgery: An Analysis of 51,362 Patients from the ACS-NSQIP

Louise L. Blankensteijn
1  Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Sebastian Sparenberg
1  Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Dustin T. Crystal
1  Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Ahmed M.S. Ibrahim
1  Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Bernard T. Lee
1  Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Samuel J. Lin
1  Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
› Author Affiliations
Funding None.

Abstract

Background In various surgical specialties, racial disparities in postoperative complications are widely reported. It is assumed that the effect of race can also be found in plastic surgical outcomes, although this remains largely undefined in literature. This study aims to provide data on the impact of race on outcomes of reconstructive breast surgery.

Methods Data were collected using the NSQIP (National Surgical Quality Improvement Program) database (2008–2016). Outcomes of the reconstructive breast surgery of White patients were compared with those of African American, Asian, or other races. Logistic regression was performed to control for variations between all groups. Analysis of racial disparities was further sub-stratified according to four different types of breast reconstruction: delayed or immediate autologous, and delayed or immediate prosthesis-based reconstruction.

Results In total, this study included 51,362 patients of which 43,864 were Caucasian, 5,135 African American, 2,057 Asian, and 332 of other races. When compared with White patients, patients of African American race had larger body mass indices (31.3 ± 7.0 vs. 27.6 ± 6.3, p-value < 0.001) in addition to higher rates of diabetes (12.3 vs 4.6%, p-value < 0.001) and hypertension (44.7 vs. 23.4%, p-value < 0.001). Both multivariate analysis and the sub-stratified analysis of different types of reconstruction showed no differences in overall complication rate.

Conclusion Among the four types of reconstructive procedures, differences in surgical outcomes do not appear to be based on race and therefore seem to be less evident in reconstructive breast surgery compared with the current literature within other surgical specialties.

Ethical Approval

The patient information in this study is deidentified and available to all institutions complying with ACS NSQIP data use agreement.


Note

The ACS NSQIP databases are the source of information used in this study. Data extrapolated, statistical analysis performed, and conclusions reach have not been verified by the ACS-NSQIP but rather are the result of the work done by authors of this study.


Supplementary Material



Publication History

Received: 15 January 2020

Accepted: 05 May 2020

Publication Date:
18 June 2020 (online)

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