Journal
BREAST JOURNAL
Volume 26, Issue 10, Pages 1966-1972Publisher
WILEY-HINDAWI
DOI: 10.1111/tbj.14029
Keywords
breast cancer; mastectomy; postoperative complications; readmission
Categories
Funding
- NCI [T32CA009621]
- Institute of Clinical and Translational Sciences [UL1 TR000448]
- National Institutes of Health [R24 HS19455]
- Agency for Healthcare Research and Quality [KM1CA156708]
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We investigated the impact of patient and operative factors on 30-day hospital readmission following mastectomy for breast cancer. Using the 2011 HCUP California State Inpatient Database, we evaluated readmissions in adult women undergoing mastectomy for invasive, in situ, or history of breast cancer. Clinical data assessment was performed using ICD-9-CM codes and the Elixhauser comorbidity index. Chi-square tests and logistic regression were used to analyze patient and operative factors and associations with 30-day hospital readmission. Of 6214 women undergoing mastectomy, 306 (4.9%) were readmitted within 30 days postoperatively, most commonly for surgical site infection (130, 42.5%) and hematoma (29, 9.5%). 30-day readmission was associated with increasing index length of stay (LOS), comorbidities, and non-private insurance (P < .05). Age, mastectomy type (unilateral vs bilateral, with vs without lymph node assessment), immediate reconstruction, and port placement during the index procedure did not significantly influence the odds of 30-day readmission. Multivariable logistic regression showed increased odds of readmission with index LOS > 2 days (OR 1.81,P < .01), metastatic disease (OR 2.16,P = .01), and Medicare insurance (OR 1.72,P < .01). Index LOS > 2 days, metastatic disease, and Medicare insurance are significant predictors of 30-day readmission following mastectomy for breast cancer. Surgical site infection and wound complications were the most common diagnoses requiring readmission and resulted in over half of readmissions in our study population at 30 days.
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