An analysis of delayed breast reconstruction outcomes as recorded in the American College of Surgeons National Surgical Quality Improvement Program.

Abstract

The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a prospective, multi-institutional clinical registry established as an auditing instrument to monitor and improve patient care in surgery. To date no publication has queried the NSQIP dataset from a plastic surgery perspective. A retrospective analysis was carried out of all delayed breast reconstruction cases recorded by the NSQIP from 2005 to 2008 (n=645). The 30-day morbidity was 5.7%, with wound infections being the most common complication. Logistic regression analysis identified BMI >25 and preoperative radiotherapy as independent risk factors for overall morbidity and wound infection. The NSQIP does not allow for capture of procedure-specific outcomes and this results in underreporting of overall morbidity compared to the literature; this may limit the capability to assess risk factors for complications. As breast reconstruction modules for NSQIP are currently under development, modifications to capture procedure-specific outcomes are recommended.