title: Predictors of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study.
abstract: OBJECTIVE
  To assess the risk of re-operation due to post-surgical bleeding after initial breast cancer surgery and to identify predictors of re-operation.
  
  
  METHODS
  We conducted a population-based study in Denmark. Patients were categorized according to age group, surgery type, and glucocorticoid use before surgery: never, current (0-90 days), and former (>90 days). We calculated the risk of re-operation due to post-surgical bleeding within 14 days after surgery, risk differences, and risk ratios of re-operation associated with age group, surgery type, and glucocorticoid use.
  
  
  RESULTS
  19,919 women were studied; 508 were re-operated. 3573 of the 19,919 women ever used glucocorticoids. Older age and mastectomy increased the risk of post-surgical bleeding compared with breast conserving surgery and younger age among both ever and never users of glucocorticoids. The crude risk of re-operation was 2.5% among never users of glucocorticoids, 2.6% among ever users and 4.0% among current users. Women aged ≥80 who were ever users of glucocorticoids and who had a mastectomy had 8.1% risk of re-operation due to post-surgical bleeding, whereas women <80 years old who never used glucocorticoids and who had breast conserving surgery had a 1.7% risk of re-operation.
  
  
  CONCLUSIONS
  Older age, mastectomy, and - in some women - glucocorticoid use add an extra risk of re-operation due to bleeding. Clinicians and their patients can use this information to evaluate the patient-specific risk of this complication.
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200 Aarhus N, Denmark. lwl@dce.au.dk
authors.forename: L
authors.initials: L
authors.lastname: Winther Lietzen
authors.forename: D
authors.initials: D
authors.lastname: Cronin-Fenton
authors.forename: J P
authors.initials: JP
authors.lastname: Garne
authors.forename: N
authors.initials: N
authors.lastname: Kroman
authors.forename: R
authors.initials: R
authors.lastname: Silliman
authors.forename: T L
authors.initials: TL
authors.lastname: Lash
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D015411:Mastectomy, Modified Radical / Q000009:adverse effects*; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D016017:Odds Ratio; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D011237:Predictive Value of Tests; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D005938:Glucocorticoids