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Increased Risk of Surgical Site Infection Among Breast-Conserving Surgery Re-excisions.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2015; Vol. 22 (6), pp. 2003-9. Date of Electronic Publication: 2014 Oct 31. - Publication Year :
- 2015
-
Abstract
- Purpose: The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer.<br />Methods: We established a retrospective cohort of women aged 18-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure or Current Procedural Terminology, 4th edition (CPT-4) codes for BCS from 29 June 2004 to 31 December 2010. Prior insurance plan enrollment of at least 180 days was required to establish the index BCS; subsequent re-excisions within 180 days were identified. SSIs occurring 2-90 days after BCS were identified by ICD-9-CM diagnosis codes. The attributable surgery was defined based on SSI onset compared with the BCS date(s). A χ (2) test and generalized estimating equations model were used to compare the incidence of SSI after index and re-excision BCS procedures.<br />Results: Overall, 23,001 women with 28,827 BCSs were identified; 23.2 % of women had more than one BCS. The incidence of SSI was 1.82 % (418/23,001) for the index BCS and 2.44 % (142/5,826) for re-excision BCS (p = 0.002). The risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman (odds ratio 1.34, 95 % confidence interval 1.07-1.68).<br />Conclusions: Surgeons need to be aware of the increased risk of SSI after re-excision BCS compared with the initial procedure. Our results suggest that risk adjustment of SSI rates for re-excision would allow for better comparison of BCS SSI rates between institutions.
- Subjects :
- Adolescent
Adult
Breast Neoplasms surgery
Carcinoma, Ductal, Breast surgery
Carcinoma, Intraductal, Noninfiltrating surgery
Female
Follow-Up Studies
Humans
Incidence
Middle Aged
Missouri epidemiology
Neoplasm Invasiveness
Neoplasm Staging
Prognosis
Reoperation
Retrospective Studies
Risk Factors
Surgical Wound Infection epidemiology
Young Adult
Breast Neoplasms complications
Carcinoma, Ductal, Breast complications
Carcinoma, Intraductal, Noninfiltrating complications
Mastectomy, Segmental adverse effects
Surgical Wound Infection etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 22
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 25358666
- Full Text :
- https://doi.org/10.1245/s10434-014-4200-x