title: Matching Procedures at the Time of Immediate Breast Reconstruction: An American College of Surgeons National Surgical Quality Improvement Program Study of 24,191 Patients.
abstract: BACKGROUND
  The purpose of this study was to assess for compounded risk of postoperative morbidity with the addition of a simultaneous contralateral breast matching procedure at the time of mastectomy and immediate breast reconstruction.
  
  
  METHODS
  2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program databases were used to identify cases of mastectomy and immediate breast reconstruction with and without simultaneous contralateral breast matching procedures. Matching procedures included mastopexy, reduction mammaplasty, and augmentation mammaplasty. Thirty-day postoperative morbidity was assessed using univariable and multivariable logistic regression.
  
  
  RESULTS
  Of 59,766 mastectomy patients, 24,191 (40 percent) underwent immediate breast reconstruction: 903 (3.7 percent) underwent matching procedures and 23,288 (96.3 percent) did not. Univariable logistic regression demonstrated that the matching procedure group had statistically significantly higher overall morbidity (OR, 1.288; 95 percent CI, 1.022 to 1.623; p = 0.032). Although surgical and systemic morbidity did not differ significantly, the matching procedure group demonstrated higher risk for superficial surgical-site infection (OR, 1.57; 95 percent CI, 1.066 to 2.31; p = 0.022), reconstruction failure (OR, 1.69; 95 percent CI, 1.014 to 2.814; p = 0.044), and pulmonary embolism (OR, 2.54; 95 percent CI, 1.01 to 6.37; p = 0.048). Controlling for possible confounders, multivariable logistic regression rendered the relationship between matching procedure and complications insignificant (OR, 1.17; 95 percent CI, 0.92 to 1.48; p = 0.2).
  
  
  CONCLUSIONS
  These data suggest that preoperative comorbidities and other patient-related factors may have a larger influence on postoperative morbidity than the addition of a contralateral matching procedure alone.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Baltimore, Md.|From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital.
authors.forename: Carisa M
authors.initials: CM
authors.lastname: Cooney
authors.affiliation: Baltimore, Md.|From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital.
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Sebai
authors.affiliation: Baltimore, Md.|From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital.
authors.forename: Onyebuchi
authors.initials: O
authors.lastname: Ogbuagu
authors.affiliation: Baltimore, Md.|From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital.
authors.forename: Chris
authors.initials: C
authors.lastname: Devulapalli
authors.affiliation: Baltimore, Md.|From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital.
authors.forename: Michele A
authors.initials: MA
authors.lastname: Manahan
authors.affiliation: Baltimore, Md.|From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital.
authors.forename: Gedge D
authors.initials: GD
authors.lastname: Rosson
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D016462:Mammaplasty / Q000379:methods* / Q000592:standards; D008408:Mastectomy; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D058996:Quality Improvement; D012189:Retrospective Studies; D012307:Risk Factors