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dc.contributor.authorSarhane, Karim A.
dc.contributor.authorFlores, José M.
dc.contributor.authorCooney, Carisa M.
dc.contributor.authorAbreu, Francis M.
dc.contributor.authorLacayo, Marcelo
dc.contributor.authorBaltodano, Pablo A.
dc.contributor.authorIbrahim, Zuhaib
dc.contributor.authorAlrakan, Mohammed
dc.contributor.authorBrandacher, Gerald
dc.contributor.authorRosson, Gedge D.
dc.date.accessioned2015-02-24T19:13:35Z
dc.date.available2015-02-24T19:13:35Z
dc.date.issued2013-08-06
dc.identifier.citationdoi:10.1097/GOX.0b013e3182a18c6fen_US
dc.identifier.issn2169-7574
dc.identifier.urihttp://jhir.library.jhu.edu/handle/1774.2/37326
dc.descriptionPMID: 25289224en_US
dc.description.abstractBackground: Preoperative anemia is independently associated with adverse outcomes after general and cardiac surgery. Outcomes after breast reconstruction are not established. We assessed the effect of preoperative anemia on 30-day postoperative morbidity and length of hospital stay (LOS) in patients undergoing immediate breast reconstruction. Methods: We identified patients undergoing immediate breast reconstruction from 2008 to 2010 from the American College of Surgeons’ National Surgical Quality Improvement Program database (a prospective outcomesbased registry from hospitals worldwide). De-identified data were obtained for demographics, preoperative risk factors, 30-day morbidity, and LOS. Morbidity variables included flap/graft/prosthesis, cardiac, respiratory, neurological, urinary, wound, and venous thromboembolism outcomes. Logistic regression assessed the crude and adjusted effect of anemia (hematocrit <36%) on postoperative 30-day morbidity. Measures of central tendency of LOS were compared across increasing severities of anemia in patients developing adverse events versus controls. Results: The study population included 10,958 patients; 1556 (16.74%) had preoperative anemia. Crude odds ratio for 30-day morbidity was significantly higher in anemic patients, unadjusted odds ratio = 1.33 (P < 0.008). This prevailed after extensive adjustment for confounding, yielding an adjusted odds ratio = 1.38 (P < 0.03). Patients who experienced adverse effects had protracted LOS, and the presence of anemia significantly amplified this effect. Conclusions: These data provide new insight into the effect of anemia in immediate breast reconstruction, demonstrating an independent association between preoperative anemia and 30-day morbidity. These findings suggest treating anemia when possible; however, prospective studies should explore the efficacy, safety, and cost-effectiveness of such treatments.en_US
dc.description.sponsorshipJH Libraries Open Access Funden_US
dc.language.isoen_USen_US
dc.publisherPlastic and reconstructive surgery. Global open.en_US
dc.relation.ispartofseriesPlastic and reconstructive surgery. Global open;v. 1 no. 5 e30
dc.subjectAmerican College of Surgeons’ National Surgical Quality Improvement Program databaseen_US
dc.subjectImmediate Breast Reconstructionen_US
dc.subjectPostoperative Outcomesen_US
dc.subjectAnemiaen_US
dc.subjectPostoperative Complicationsen_US
dc.titlePreoperative anemia and postoperative outcomes in immediate breast reconstructive surgery : a critical analysis of 10,958 patients from the ACS-NSQIP databaseen_US
dc.typeArticleen_US


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