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Background <p>While prior research indicates that lower socioeconomic status (SES) poses potential barriers to eligibility and completion of breast reconstruction, the influence of SES on post-operative outcomes in breast reconstruction remains largely unexplored. This study aimed to compare the short-term outcomes of patients from low-income versus high-income neighborhoods who underwent autologous breast reconstruction (ABR) and implant-based breast reconstruction (IBR) using a national registry.</p> Methods <p>Patients undergoing ABR or IBR were identified in National Inpatient Sample from Q4 2015–2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients living in neighborhood income at the lowest and highest quartiles, adjusted for demographics, comorbidities, primary payer status, and hospital characteristics.</p> Results <p>Among 12,818 ABR patients, 2,102 (16.4%) and 4,948 (38.6%) came from neighborhood income at the lowest and highest quartiles, respectively. Of 17,751 IBR patients, 2,676 (15.08%) were from low-income and 7,211 (40.62%) were from high-income communities. Outcomes for ABR were largely comparable between patients of low and high SES, with exception of higher vascular complications in low SES patients (aOR = 3.482, 95% CI = 1.755–6.91, <i>p</i> &lt; 0.01). Patients from low-income neighborhoods had higher risks of wound dehiscence (aOR = 1.872, 95% CI 1.19–2.947, <i>p</i> = 0.01), superficial wound complications (aOR = 1.324, 95% CI = 1.035–1.694, <i>p</i> = 0.03), seroma (aOR = 1.567, 95% CI = 1.032–2.38, <i>p</i> = 0.03), hemorrhage/hematoma (aOR = 1.351, 95% CI = 1.046–1.744, <i>p</i> = 0.02), and vascular complications (aOR = 5.068, 95% CI = 1.355–18.946, <i>p</i> = 0.02) but less capsular contracture (aOR = 0.679, 95% = CI 0.481–0.957, <i>p</i> = 0.03).</p> Conclusions <p>Potential disparities exist for low-income patients to access breast reconstructions. Addressing this disparity is essential, as is the need to mitigate post-operative complications in low-income patients, especially in IBR.&#xa0;</p> <p>Level of evidence: Level III, risk/prognostic study</p>

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Socioeconomic disparity in autologous and implant-based breast reconstruction: a population study of National Inpatient Sample from 2015–2020

  • 期刊论文

  • 发表日期：

    2025年2月5日

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  • Renxi Li

摘要

Background

While prior research indicates that lower socioeconomic status (SES) poses potential barriers to eligibility and completion of breast reconstruction, the influence of SES on post-operative outcomes in breast reconstruction remains largely unexplored. This study aimed to compare the short-term outcomes of patients from low-income versus high-income neighborhoods who underwent autologous breast reconstruction (ABR) and implant-based breast reconstruction (IBR) using a national registry.

Methods

Patients undergoing ABR or IBR were identified in National Inpatient Sample from Q4 2015–2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients living in neighborhood income at the lowest and highest quartiles, adjusted for demographics, comorbidities, primary payer status, and hospital characteristics.

Results

Among 12,818 ABR patients, 2,102 (16.4%) and 4,948 (38.6%) came from neighborhood income at the lowest and highest quartiles, respectively. Of 17,751 IBR patients, 2,676 (15.08%) were from low-income and 7,211 (40.62%) were from high-income communities. Outcomes for ABR were largely comparable between patients of low and high SES, with exception of higher vascular complications in low SES patients (aOR = 3.482, 95% CI = 1.755–6.91, p < 0.01). Patients from low-income neighborhoods had higher risks of wound dehiscence (aOR = 1.872, 95% CI 1.19–2.947, p = 0.01), superficial wound complications (aOR = 1.324, 95% CI = 1.035–1.694, p = 0.03), seroma (aOR = 1.567, 95% CI = 1.032–2.38, p = 0.03), hemorrhage/hematoma (aOR = 1.351, 95% CI = 1.046–1.744, p = 0.02), and vascular complications (aOR = 5.068, 95% CI = 1.355–18.946, p = 0.02) but less capsular contracture (aOR = 0.679, 95% = CI 0.481–0.957, p = 0.03).

Conclusions

Potential disparities exist for low-income patients to access breast reconstructions. Addressing this disparity is essential, as is the need to mitigate post-operative complications in low-income patients, especially in IBR. 

Level of evidence: Level III, risk/prognostic study