ArticleJournal of the American College of Surgeons2021
Outpatient Mastectomy: Factors Influencing Patient Selection and Predictors of Return to Care.
Article in Journal of the American College of Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 34 citations in OpenAlex.
- Patient-Reported Outcomes After Same-Day Mastectomy Among Older Breast Cancer Patients: Results From a Prospective Clinical Trial.The breast journal · 2025Trial
- Post-Mastectomy Emergency Department Visits in Alberta: Understanding Patient Perspectives.Current oncology (Toronto, Ont.) · 2026Article
- Outpatient Mastectomy with Reconstruction at Ambulatory Surgery Centers.Annals of surgical oncology · 2026Article
- Unplanned Emergency Department Visits Within 90 Days of Breast Reduction Surgery: A Retrospective Cohort Study.Plastic surgery (Oakville, Ont.) · 2026Article
- Article
- Topical tranexamic acid in mastectomies on haematoma formation: prospective cohort study.BJS open · 2025Article
- The succession of One Day Surgery with Breast Cancer Home Recovery Program by the National Cancer Institute (ODS BHR NCI) during the COVID-19 pandemic in Thailand.Surgery open science · 2025Review
- Creating pragmatic, rapid-cycle, evidence-based innovation: The Kaiser Permanente Northern California Delivery Science and Applied Research (DARE) program.Learning health systems · 2025Article
- National Patterns of Hospital Admission Versus Home Recovery Following Mastectomy for Breast Cancer.Annals of surgical oncology · 2024Article
- Remote Symptom Monitoring with Clinical Alerts Following Mastectomy: Do Early Symptoms Predict 30-Day Surgical Complications.Annals of surgical oncology · 2024Article
- Inpatient versus Outpatient Immediate Alloplastic Breast Reconstruction: Recent Trends, Outcomes, and Safety.Plastic and reconstructive surgery. Global open · 2023Article
- Value of Ambulatory Modified Radical Mastectomy.Annals of surgical oncology · 2023Article
- Choice of Hospital Setting for Modified Radical Mastectomy: Difference in Value?Annals of surgical oncology · 2023Article
- Surgeon Factors Influencing Breast Surgery Outcomes: A Scoping Review to Define the Modern Breast Surgical Oncologist.Annals of surgical oncology · 2023Article
- Patient Experience and Clinical Outcomes after Same-day Outpatient Mastectomy and Immediate Breast Reconstruction Protocol during the Global Pandemic.Plastic and reconstructive surgery. Global open · 2023Article
- The Impact of Same-Day Discharge and Enhanced Recovery on Patient Quality of Life After Mastectomy with Implant Reconstruction.Annals of surgical oncology · 2023Article
- How to teach ERAS protocols: surgical residents' perspectives and perioperative practices for breast surgery patients.Global surgical education : journal of the Association for Surgical Education · 2023Article
- Home Recovery After Mastectomy: Review of Literature and Strategies for Implementation American Society of Breast Surgeons Working Group.Annals of surgical oncology · 2022Review
- Profitability of the CMA Unit for breast pathology during the COVID-19 pandemic.Cirugia espanola · 2022Article
- Care in the time of COVID-19: impact on the diagnosis and treatment of breast cancer in a large, integrated health care system.Breast cancer research and treatment · 2022Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter implementation of the Surgical Home Recovery (SHR) initiative for mastectomy within a large, integrated health delivery system, most patients are discharged on the day of the procedure. We sought to identify predictors of SHR and unplanned return to care (RTC). STUDY
designMastectomy cases with and without reconstruction from October 2017 to August 2019 were analyzed. Patient characteristics, operative variables, and multimodal pain management were compared between admitted patients and SHR patients using logistic regression. We identified predictors of RTC in SHR patients, defined as 7-day readmission, reoperation, or emergency department visit.
resultsOf 2,648 mastectomies, 1,689 (64%) were outpatient procedures and the mean age of patients was 58.5 years. Predictors of SHR included perioperative IV acetaminophen (odds ratio [OR] 1.59; 95% CI, 1.28 to 1.97), perioperative opiates (OR 1.47; 95% CI, 1.06 to 2.02), and operation performed by a high-volume breast surgeon (OR 2.12; 95% CI, 1.42 to 3.18). Bilateral mastectomies (OR 0.70; 95% CI, 0.54 to 0.91), immediate reconstruction (OR 0.52; 95% CI, 0.39 to 0.70), and American Society of Anesthesiologists class 3 to 4 (OR 0.69; 95% CI, 0.54 to 0.87) decreased the odds of SHR. Of SHR patients, 111 of 1,689 patients (7%) experienced RTC. Patients with American Society of Anesthesiologists class 3 to 4 (OR 2.01; 95% CI, 1.29 to 3.14) and African American race (OR 2.30; 95% CI, 1.38 to 4.91) were more likely to RTC; receiving IV acetaminophen (OR 0.56; 95% CI, 0.35 to 0.88) and filling an opiate prescription (OR 0.51; 95% CI, 0.34 to 0.77) decreased the odds of RTC.
conclusionsSurgeon volume and multimodal pain medication increased the odds of SHR. Within the SHR group, American Society of Anesthesiologists Class 3 to 4 and African American patients increased the likelihood of RTC. This study helps optimize patient selection and perioperative practice for successful SHR.
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