Utilization of mastectomy and reconstruction in the outpatient setting.
Utilization of mastectomy and reconstruction in the outpatient setting.
复制标题
DOI：
10.1245/s10434-012-2661-3
复制
发表时间：
2013-03
影响因子：
3.7
通讯作者：
Chen SL
中科院分区：
文献类型：
--
作者：
Kruper L;Xu XX;Henderson K;Bernstein L;Chen SL
据报道，乳房切除术后的重建率在 25-40% 之间；然而，大多数研究都集中在住院治疗的患者身上。我们试图确定南加州门诊乳房切除术和乳房重建术的使用情况。乳房切除术后重建率是根据 2006 年至 2009 年加州全州健康规划和发展办公室数据库使用 CPT 代码确定的，并且类似地根据使用 ICD-9 代码的住院患者数据库确定的。比较住院患者和门诊患者的重建率。对于门诊患者，采用 95% 置信区间的单变量和多变量比值比来估计立即重建与单独乳房切除术的相对几率。接受门诊乳房切除术的患者占所有接受乳房切除术患者总数的20.4%至23.9%。住院患者立即重建的比例从 29.2% 增加到 41.6%（总体比率 35.5%），而接受重建的门诊患者比例仅从 7.7% 增加到 10.3%（总体比率 9.1%）。与住院环境类似，在多变量分析中，年龄、保险状况、种族/民族和医院类型与门诊环境中重建的使用显着相关。大量患者接受门诊乳房切除术，但重建率较低。虽然对于那些不选择重建的人来说，选择门诊乳房切除术肯定可能代表一种选择偏差，但门诊乳房切除术使用的增加可能会导致乳房切除术后重建使用的减少。
Reconstruction rates after mastectomy have been reported to range from 25–40 %; however, most studies have focused on patients treated in an inpatient setting. We sought to determine the utilization of outpatient mastectomy and use of breast reconstruction in Southern California. Postmastectomy reconstruction rates were determined from the California Office of Statewide Health Planning and Development database from 2006–2009 using CPT codes and similarly from an inpatient database using ICD-9 codes. Reconstruction rates were compared between the inpatient and outpatient setting. For the outpatient setting, univariate and multivariate odds ratios with 95 % confidence intervals were estimated for relative odds of immediate reconstruction versus mastectomy alone. The percentage of patients undergoing outpatient mastectomy ranged from 20.4 to 23.9 % of the total number of all patients undergoing mastectomy. Whereas immediate inpatient reconstruction increased from 29.2 to 41.6 % (overall rate 35.5 %), the proportion of outpatients undergoing reconstruction only increased from 7.7 to 10.3 % (overall rate 9.1 %). Similar to the inpatient setting, in multivariate analysis, age, insurance status, race/ethnicity, and type of hospital were significantly associated with the use of reconstruction in the outpatient setting. A substantial number of patients undergo outpatient mastectomy with low rates of reconstruction. Although the choice of an outpatient mastectomy may certainly represent a selection bias for those not choosing reconstruction, an increase in the use of outpatient mastectomy may result in decreases in the use of post-mastectomy reconstruction.
登录
查看更多内容
影响因子：
3.7
作者：
Kruper, Laura;Holt, Alicia;Ellenhorn, Joshua
通讯作者：
Ellenhorn, Joshua
影响因子：
3.6
作者：
Lu, L;Fine, NA
通讯作者：
Fine, NA
影响因子：
2.9
作者：
Pacik, Peter T;Nelson, Craig E;Werner, Catherine
通讯作者：
Werner, Catherine
DOI：
10.1016/j.jamcollsurg.2007.03.030
发表时间：
2007-09-01
影响因子：
5.2
作者：
Simpson, Scott A.;Ying, Benjamin L.;Bernik, Stephanie F.
通讯作者：
Bernik, Stephanie F.
影响因子：
3
作者：
Ferrante, J;Gonzalez, E;Roetzheim, R
通讯作者：
Roetzheim, R