Carol Wang, Jamie Frost, Megan Tang, Reanna Shah, Esther Kim, Peter E. Shamamian, Keisha E. Montalmant, Olachi Oleru, Nargiz Seyidova, Peter W. Henderson
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引用次数: 0
Abstract
Purpose
The Area Deprivation Index (ADI) ranks neighborhoods by deprivation based on US Census data. This study utilizes ADI scores to investigate the impact of neighborhood deprivation on complication rates following breast reconstruction.
Patients and methods
Patients who received implant-based reconstruction from 2019 to 2023 were identified at a single institution in New York. Patients were linked to a state-specific ADI score and categorized into groups: “High ADI” (6-10) and “Low ADI” (1-5). Patient characteristics and complication rates were compared between the ADI groups with Chi-Square analysis and t-tests. The predictive value of ADI scores on complication rates was assessed using logistic regression models.
Results
In total, 471 patients were included, of which 16% (n = 73) were in the High ADI group, and 84% (n = 398) were in the Low ADI group. There were no baseline differences between the 2 groups, except that there were more patients of Hispanic descent in the High ADI group (30% vs. 15%, P < .01). The High ADI group had a higher overall complication rate than the Low ADI group (34% vs. 21%, P < .01), as well as higher individual rates of hematoma (12% vs. 3%, P < .01) and unexpected reoperations (18% vs. 7%, P < .01). After adjusting for differences in race, High ADI scores predicted hematoma, reoperations, and any complication (P < .05).
Conclusion
Patients living in neighborhoods with high ADI had a higher incidence of postoperative complications, independent of comorbidities and race. This measure of disparity should be considered when counselling patients about their risk of complications following procedures like implant-based breast reconstruction.
目的:根据美国人口普查数据,地区贫困指数(ADI)按贫困程度对社区进行排名。本研究利用 ADI 分数来调查邻里贫困对乳房重建后并发症发生率的影响:在纽约的一家机构确定了 2019 年至 2023 年期间接受植入式重建的患者。患者与特定州的 ADI 分数相关联,并被分为不同组别:"高ADI "组(6-10分)和 "低ADI "组(1-5分)。通过 Chi-Square 分析和 t 检验比较了 ADI 组之间的患者特征和并发症发生率。使用逻辑回归模型评估了 ADI 评分对并发症发生率的预测价值:共纳入 471 名患者,其中高 ADI 组占 16%(n = 73),低 ADI 组占 84%(n = 398)。两组之间没有基线差异,只是高 ADI 组中西班牙裔患者较多(30% 对 15%,P < .01)。高 ADI 组的总体并发症发生率高于低 ADI 组(34% 对 21%,P < .01),血肿发生率(12% 对 3%,P < .01)和意外再手术发生率(18% 对 7%,P < .01)也高于低 ADI 组。在对种族差异进行调整后,高ADI评分可预测血肿、再次手术和任何并发症(P < .05):结论:居住在 ADI 较高地区的患者术后并发症发生率较高,与合并症和种族无关。在向患者提供有关植入物乳房再造等手术后并发症风险的咨询时,应考虑到这一差异指标。
期刊介绍:
Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.