Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data
Background:. We analyzed patient outcomes after deep inferior epigastric perforator (DIEP) flap reconstruction using a national database to assess readmission, mortality, morbidity, and length of stay (LOS). Methods:. This retrospective cohort study utilized the 2017–2020 Nationwide Readmissions Dat...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-02-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006536 |
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| author | Sthefano Araya, MD Heather Peluso, DO Nathan Doremus, MD Jaina Lane, MD Heli Patel, BS, MBA Lindsay Talemal, BS Daniel Najafali, BS Alexander H. Chang, BA, MS Sameer A. Patel, MD, FACS |
| author_facet | Sthefano Araya, MD Heather Peluso, DO Nathan Doremus, MD Jaina Lane, MD Heli Patel, BS, MBA Lindsay Talemal, BS Daniel Najafali, BS Alexander H. Chang, BA, MS Sameer A. Patel, MD, FACS |
| author_sort | Sthefano Araya, MD |
| collection | DOAJ |
| description | Background:. We analyzed patient outcomes after deep inferior epigastric perforator (DIEP) flap reconstruction using a national database to assess readmission, mortality, morbidity, and length of stay (LOS).
Methods:. This retrospective cohort study utilized the 2017–2020 Nationwide Readmissions Database. Patients had an International Classification of Diseases, Tenth Revision procedure code for DIEP flap reconstruction from January to November each year. The primary outcome was the 30-day readmission rate, with secondary outcomes including in-hospital and 30-day mortality, reasons for admission and readmission, and complication rates. Multivariate regression adjusted for confounders.
Results:. A total of 32,019 DIEP flap reconstructions were identified, with a median patient age of 51 years. The most common indication was breast reconstruction after mastectomy. In-hospital, 30-day, and calendar-year mortality rates were all under 1% (95% confidence interval [CI]: 1.29–3.99). The 30-day readmission rate was 5.8% (95% CI: 5.4%–6.3%), with infection being the leading cause of readmission (2.0%), a previously unreported finding. Other causes included wound dehiscence (0.19%), pulmonary embolism (0.19%), sepsis (0.18%), and hematoma (0.18%). Reoperation rates were 7% during the index hospitalization and 11% during readmission. The average LOS was 3.7 days (95% CI: 3.65–3.82), consistent with current literature.
Conclusions:. This study provides valuable insights into DIEP flap reconstruction outcomes, revealing a 2.0% infection readmission rate. It shows a higher overall readmission rate (7% versus 5.6%) and a lower dehiscence rate (0.2% versus 2.8%) compared with previous data. These findings, derived from the largest nationally representative readmission database in the United States, also demonstrate comparable reoperation rates and LOS. |
| format | Article |
| id | doaj-art-fb1d1456317244a2a39b8db6a9987b38 |
| institution | DOAJ |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-fb1d1456317244a2a39b8db6a9987b382025-08-20T02:45:37ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-02-01132e653610.1097/GOX.0000000000006536202502000-00053Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission DataSthefano Araya, MD0Heather Peluso, DO1Nathan Doremus, MD2Jaina Lane, MD3Heli Patel, BS, MBA4Lindsay Talemal, BS5Daniel Najafali, BS6Alexander H. Chang, BA, MS7Sameer A. Patel, MD, FACS8From the * Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, PAFrom the * Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, PA‡ Department of General Surgery, Temple University Hospital, Philadelphia, PA‡ Department of General Surgery, Temple University Hospital, Philadelphia, PA§ Kiran C Patel College of Allopathic Medicine, Nova Scotia University, Fort Lauderdale, FL¶ Lewis Katz School of Medicine, Temple University, Philadelphia, PA∥ Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL.From the * Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, PAFrom the * Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, PABackground:. We analyzed patient outcomes after deep inferior epigastric perforator (DIEP) flap reconstruction using a national database to assess readmission, mortality, morbidity, and length of stay (LOS). Methods:. This retrospective cohort study utilized the 2017–2020 Nationwide Readmissions Database. Patients had an International Classification of Diseases, Tenth Revision procedure code for DIEP flap reconstruction from January to November each year. The primary outcome was the 30-day readmission rate, with secondary outcomes including in-hospital and 30-day mortality, reasons for admission and readmission, and complication rates. Multivariate regression adjusted for confounders. Results:. A total of 32,019 DIEP flap reconstructions were identified, with a median patient age of 51 years. The most common indication was breast reconstruction after mastectomy. In-hospital, 30-day, and calendar-year mortality rates were all under 1% (95% confidence interval [CI]: 1.29–3.99). The 30-day readmission rate was 5.8% (95% CI: 5.4%–6.3%), with infection being the leading cause of readmission (2.0%), a previously unreported finding. Other causes included wound dehiscence (0.19%), pulmonary embolism (0.19%), sepsis (0.18%), and hematoma (0.18%). Reoperation rates were 7% during the index hospitalization and 11% during readmission. The average LOS was 3.7 days (95% CI: 3.65–3.82), consistent with current literature. Conclusions:. This study provides valuable insights into DIEP flap reconstruction outcomes, revealing a 2.0% infection readmission rate. It shows a higher overall readmission rate (7% versus 5.6%) and a lower dehiscence rate (0.2% versus 2.8%) compared with previous data. These findings, derived from the largest nationally representative readmission database in the United States, also demonstrate comparable reoperation rates and LOS.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006536 |
| spellingShingle | Sthefano Araya, MD Heather Peluso, DO Nathan Doremus, MD Jaina Lane, MD Heli Patel, BS, MBA Lindsay Talemal, BS Daniel Najafali, BS Alexander H. Chang, BA, MS Sameer A. Patel, MD, FACS Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data Plastic and Reconstructive Surgery, Global Open |
| title | Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data |
| title_full | Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data |
| title_fullStr | Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data |
| title_full_unstemmed | Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data |
| title_short | Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data |
| title_sort | outcomes of 32 019 deep inferior epigastric perforator flap reconstructions insights from the largest national readmission data |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006536 |
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