AAPS Main Site
Annual Meeting Home
Final Program
Past & Future Meetings


Back to 2015 Annual Meeting Posters


Lack of Validity of the ACS-NSQIP Database for Alloplastic Post-Mastectomy Reconstruction
John Compoginis, MD, Edward Luce, MD, Charles Pierce, MD.
University of Tennessee Health Sciences, Memphis, TN, USA.

Purpose:
The ACS-NSQIP is an outcomes-based program with the objective to improve quality of surgical care. Attracted by size and validity, the ACS-NSQIP database has been mined by both general and plastic surgery clinical researchers to provide information for possible risk reduction strategies and patient counseling. Yet, the 30-day window of the ACS-NSQIP database may be inappropriately brief in documentation of complications for some operative procedures. For example, the database was recently examined for the incidence of readmission following immediate post-mastectomy reconstruction1.
Methods:
The hypothesis was the ACS-NSQIP database under-estimated complications in alloplastic reconstruction, in particular, prosthesis loss. A cohort2 of immediate post-mastectomy reconstruction with tissue expanders was reviewed for the hiatus between implantation and prosthesis loss (explantation).
Results:
Of 511 breasts reconstructed with immediate placement of tissue expanders, 55 were explanted due to infection and/or exposure. Of the total, 19 were explanted in 30 days or less, 36 afterward, a mean of 62.1 and median of 43 days (Figure1).
Conclusion:
The ACS-NSQIP database, originally developed for application to general and vascular surgery, may not be appropriate for analysis of post-mastectomy alloplastic breast reconstruction complications.
1. Nelson JA, Fischer JP, PRS, (2014); 134:193e-201e.
2. Parks JW, et al., PRS, (2012); 130:739-746.


Back to 2015 Annual Meeting Posters