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Breast Reconstruction Surgery Readmission Rates are higher in Patients with both Anemia and Hypoalbuminemia
Oleksandr Trofymenko, M.Ed.1, Edvin Telemi, B.S.1, Raghunandan Venkat, M.D., MPH2, Ethan Larson, M.D.2.
1University of Arizona College of Medicine - Tucson, Tucson, AZ, USA, 2University of Arizona, Department of Surgery, Tucson, AZ, USA.

PURPOSE:
Anemia is relatively prevalent among women, and to our knowledge, it has not been linked to complications following breast reconstruction surgery. In this study we examine the impact of anemia, hypoalbuminemia, as well as the compounded impact of both factors on readmission rates in patients following surgical breast reconstruction.
METHODS:
The NSQIP database was queried using CPT codes to identify 5,870 female patients undergoing breast reconstruction surgery in 2011 and 2012. Anemia was defined as preoperative serum hematocrit <36% for women. Hypoalbuminemia was defined as preoperative serum albumin <3.5g/dL. We selected the previously described outcome parameters of hospital readmission and re-operation following surgery to investigate. We used both univariate analysis and multivariate regression analysis, which accounted for demographic factors, comorbidities, and operative details that were performed.
RESULTS:
Our dataset included 78 hypoalbuminemic; 1,129 anemic; and 39 patients with both conditions simultaneously. On univariate analysis, hypoalbuminemia alone was not found to be associated with significantly higher readmission or reoperation rates. Anemia alone also did not significantly correlate with increase in readmission and re-operation rates. However, patients with both conditions showed increased readmission rates from 4.86% to 12.82% (p=0.041) but did not show significantly higher re-operation rates. On multivariate analysis the co-occurrence of hypoalbuminemia and anemia was an independent predictor of readmission rates (Adjusted Odd Ratio: 3.79, p=0.011).
CONCLUSION:
Combined impact of anemia and hypoalbuminemia is associated with hospital readmissions following reconstructive breast surgery. Considering the confounding effect of both factors can help identify the otherwise overlooked high-risk patients.


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