Plastic Surgery Research Council
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Presenter: Toni Zhong MD, MHS
Co-Authors: Bagher S; Zeng D, Metacalf K, Hofer S
university health network

Objective: Decision regret has increasingly become regarded as an important endpoint for evaluating decision-making in health-care. The objective of this study was to determine the association between complication and regret following abdominally based microsurgical breast reconstruction.

Background: Although microsurgical techniques using perforator flaps from the abdomen have been designed to decrease abdominal wall morbidity, major postoperative complications can still arise and may contribute to a patient regretting to undergo this procedure. Both the factors that can contribute to complications as well as regret following abdominally-based microsurgical breast reconstruction are important.

Methods: This is a retrospective cross sectional analysis of 189 patients who have undergone abdominally-based microsurgical breast reconstruction from 2003 to 2010. Primary Outcome: Decision Regret. Intermediate Outcome: Major postoperative complications. Analysis: A multivariable model examined the association between major complications and decision regret after controlling for patient s pessimism/optimism using the LOTR (life-orientation test revised) measure, sociodemographic status, and time since reconstruction.

Results: The odds of developing major complications increased significantly with increasing BMI (OR=5.7), immediate reconstruction (OR=4.5), and previous abdominal surgery and pregnancy (OR=0.89). The presence of major complications was not significantly associated with decision regret on the multivariable analysis. However, in patients who suffered major complications, those who had higher levels of education had significantly less regret than those who were less educated (OR=0.62). In addition, patient factors that significantly increased regret scores were non-white ethnicity and patients who were more pessimistic on the LOTR measure.

Conclusion: Major complications did not significantly contribute to patient s decision regret to undergo microsurgical breast reconstruction after controlling for patient characteristics.

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