National Patterns of Hospital Admission Versus Home Recovery Following Mastectomy for Breast Cancer
Document Type
Article
Publication Title
Annals of surgical oncology
Abstract
BACKGROUND: We examined national patterns of care and perioperative outcomes for women after mastectomy, comparing home recovery (HR) with hospital admission. PATIENTS AND METHODS: Using Martketscan data (2017-2019), women ≥ 18 years old who underwent mastectomy ± reconstruction were identified and classified as either home recovery (same calendar day discharge) or hospital admission (stays > 1 calendar day). Comorbidities and receipt of chemo/immunotherapy 6 months prior to surgery and post-surgical 30-day complications were measured. Logistic regression calculated the odds of any complication by encounter type, adjusting for age, accompanying lymph node (LN) procedure, reconstruction, neoadjuvant chemo- and/or immunotherapy, and select comorbidities. RESULTS: Of 11,789 mastectomy encounters (N = 11,659 women), 4751 (40%) cases utilized HR while 7038 (60%) had hospital admission. HR patients were older (53.6 years old vs. 51.8 years old) with lower rates of reconstruction (60.2 vs. 74.5%, p < 0.001). Rates of neoadjuvant chemotherapy (19.6 vs. 20.9%, p = 0.099) and immunotherapy (3.6 vs. 3.9%, p = 0.445) were similar between groups. Complication rates were lower among HR patients with fewer postoperative hematomas (0.6 vs. 1.3%, p < 0.001) and decreased wound complications (8.5 vs. 9.8%, p = 0.019). In a multivariable analysis, the odds of any complication were approximately 20% lower for HR patients compared with admission patients (aOR 0.81, 95% CI 0.72-0.91, p < 0.001). Unplanned emergency room visits were similar between groups (6.7 vs. 7.2%, p = 0.374); yet fewer hospital re-admissions (2.5 vs. 3.5%, p = 0.003) occurred in women recovering at home. CONCLUSION: HR is a safe option compared with in-hospital admission for clinically appropriate women after mastectomy as they are less likely to experience postoperative complications, emergency department (ED) visits, or hospitalization.
First Page
9088
Last Page
9099
DOI
10.1245/s10434-024-16107-w
Publication Date
12-1-2024
Recommended Citation
Kim, Leah S.; Moore, Miranda S.; Schneider, Eric; Canner, Joseph; Ayyala, Haripriya; Chen, Judy; Anant, Pavan; Graetz, Elena; Lynch, Melanie A.; Zanieski, Gregory; Gillego, Alyssa; Valero, Monica G.; Proussaloglou, Ellie M.; Berger, Elizabeth R.; Golshan, Mehra; Greenup, Rachel A.; and Park, Tristen S., "National Patterns of Hospital Admission Versus Home Recovery Following Mastectomy for Breast Cancer" (2024). Internal Medicine. 212.
https://scholar.bridgeporthospital.org/internal_medicine/212
Identifier
39322830 (pubmed); 10.1245/s10434-024-16107-w (doi); 10.1245/s10434-024-16107-w (pii)