title: The safety of same-day breast reconstructive surgery: An analysis of short-term outcomes.
abstract: BACKGROUND
  We sought to examine the safety of same-day breast reconstructive (BR) surgery.
  
  
  METHODS
  An analysis of the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP) files was performed. Patients undergoing BR for breast cancer were examined, excluding those with high-risk co-morbidities or concurrent surgery. A propensity score was calculated and a multivariable logistic regression analysis was used to calculate the difference in 30-day complications between those undergoing SDS versus longer hospital stay.
  
  
  RESULTS
  The study consisted of 21,539 patients; 17,449 had implant and 4090 had autologous breast reconstruction. 1195 (5.5%) underwent SDS, whereas 20,344 (94.5%) were admitted at least overnight. On unadjusted analysis, the rate of post-operative complications was nearly three times higher in those admitted compared to those undergoing SDS (6.7% vs. 2.5%; p < 0.001). On propensity score adjusted multivariable regression there was no significant difference in complications amongst those undergoing SDS versus staying in hospital (OR 1.4 (95%CI: 0.9, 2.2)).
  
  
  CONCLUSIONS
  These results suggest that admitting BR patients does not prevent short-term complications and same day BR surgery is safe when co-morbidities are accounted for.
authors.affiliation: Division of General Surgery, The Ottawa Hospital, Ottawa, ON, Canada. Electronic address: ecordeiro@toh.on.ca.
authors.forename: Erin
authors.initials: E
authors.lastname: Cordeiro
authors.affiliation: Division of Plastic and Reconstructive Surgery, University Health Network, Toronto, ON, Canada; Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Toni
authors.initials: T
authors.lastname: Zhong
authors.affiliation: Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of General Surgery, University Health Network, Toronto, ON, Canada.
authors.forename: Timothy
authors.initials: T
authors.lastname: Jackson
authors.affiliation: Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of General Surgery, University Health Network, Toronto, ON, Canada; Department of Surgery, Women's College Hospital, Toronto, ON, Canada.
authors.forename: Tulin
authors.initials: T
authors.lastname: Cil
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects; D008408:Mastectomy; D008875:Middle Aged; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Breast cancer; Breast reconstruction; Same-day surgery