Risk factors for complications following immediate tissue expander based breast reconstruction in Taiwanese population

Che Wei Chang, Hao Chih Tai, Nai Chen Cheng, Wei Tang Li, Hong Shiee Lai, Hsiung Fei Chien

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background/Purpose Breast cancer patients in Asia show considerable disparities from Caucasian patients, such as younger age of onset and lower rates of smoking, obesity, and diabetes. Findings of prior studies regarding risk factors associated with complications in tissue expander may not hold for Asian populations, since most of these studies involved Caucasian patients. In this study, we surveyed risk factors in the Taiwanese population, providing additional evidence about the important differences and discuss the implications for clinical practice. Methods Patients who underwent immediate, two-stage, tissue expander breast reconstruction from December 2008 to August 2014 in the National Taiwan University Hospital, Taipei, Taiwan were included. Follow-up observations of all patients were conducted until December 2014. Complications occurring during the tissue expander stage were evaluated. Multivariate regression modeling was used to identify risk factors for complications. Results A total of 246 consecutive, immediate, smooth round tissue expander placements were performed for breast reconstruction. The most common complication was skin necrosis (4.9%), followed by wound dehiscence (4.1%). In the multivariate model, body mass index (BMI) ≥ 24 kg/m2 was the only risk factor that reached statistical significance (odds ratio: 2.41, 95% confidence interval: 1.17–4.96). Conclusion We provided evidence that racial disparities have an impact on the risk factors for complications associated with tissue expander breast reconstruction. BMI ≥ 24 kg/m2 was the only risk factor significantly associated with complications. Clinically, BMI ≥ 24 kg/m2, rather than the standard definition of obesity (BMI > 30 kg/m2), may be a more suitable cutoff point for risk in patients of Asian ethnicity.

Original languageEnglish
Pages (from-to)57-63
Number of pages7
JournalJournal of the Formosan Medical Association
Volume116
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

Fingerprint

Tissue Expansion Devices
Mammaplasty
Population
Taiwan
Body Mass Index
Obesity
Age of Onset
Necrosis
Smoking
Odds Ratio
Confidence Intervals
Breast Neoplasms
Skin
Wounds and Injuries

Keywords

  • Asia population
  • Breast reconstruction
  • Complications
  • Racial disparity
  • Risk factor
  • Tissue expander

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Risk factors for complications following immediate tissue expander based breast reconstruction in Taiwanese population. / Chang, Che Wei; Tai, Hao Chih; Cheng, Nai Chen; Li, Wei Tang; Lai, Hong Shiee; Chien, Hsiung Fei.

In: Journal of the Formosan Medical Association, Vol. 116, No. 1, 01.01.2017, p. 57-63.

Research output: Contribution to journalArticle

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abstract = "Background/Purpose Breast cancer patients in Asia show considerable disparities from Caucasian patients, such as younger age of onset and lower rates of smoking, obesity, and diabetes. Findings of prior studies regarding risk factors associated with complications in tissue expander may not hold for Asian populations, since most of these studies involved Caucasian patients. In this study, we surveyed risk factors in the Taiwanese population, providing additional evidence about the important differences and discuss the implications for clinical practice. Methods Patients who underwent immediate, two-stage, tissue expander breast reconstruction from December 2008 to August 2014 in the National Taiwan University Hospital, Taipei, Taiwan were included. Follow-up observations of all patients were conducted until December 2014. Complications occurring during the tissue expander stage were evaluated. Multivariate regression modeling was used to identify risk factors for complications. Results A total of 246 consecutive, immediate, smooth round tissue expander placements were performed for breast reconstruction. The most common complication was skin necrosis (4.9{\%}), followed by wound dehiscence (4.1{\%}). In the multivariate model, body mass index (BMI) ≥ 24 kg/m2 was the only risk factor that reached statistical significance (odds ratio: 2.41, 95{\%} confidence interval: 1.17–4.96). Conclusion We provided evidence that racial disparities have an impact on the risk factors for complications associated with tissue expander breast reconstruction. BMI ≥ 24 kg/m2 was the only risk factor significantly associated with complications. Clinically, BMI ≥ 24 kg/m2, rather than the standard definition of obesity (BMI > 30 kg/m2), may be a more suitable cutoff point for risk in patients of Asian ethnicity.",
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AU - Chien, Hsiung Fei

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N2 - Background/Purpose Breast cancer patients in Asia show considerable disparities from Caucasian patients, such as younger age of onset and lower rates of smoking, obesity, and diabetes. Findings of prior studies regarding risk factors associated with complications in tissue expander may not hold for Asian populations, since most of these studies involved Caucasian patients. In this study, we surveyed risk factors in the Taiwanese population, providing additional evidence about the important differences and discuss the implications for clinical practice. Methods Patients who underwent immediate, two-stage, tissue expander breast reconstruction from December 2008 to August 2014 in the National Taiwan University Hospital, Taipei, Taiwan were included. Follow-up observations of all patients were conducted until December 2014. Complications occurring during the tissue expander stage were evaluated. Multivariate regression modeling was used to identify risk factors for complications. Results A total of 246 consecutive, immediate, smooth round tissue expander placements were performed for breast reconstruction. The most common complication was skin necrosis (4.9%), followed by wound dehiscence (4.1%). In the multivariate model, body mass index (BMI) ≥ 24 kg/m2 was the only risk factor that reached statistical significance (odds ratio: 2.41, 95% confidence interval: 1.17–4.96). Conclusion We provided evidence that racial disparities have an impact on the risk factors for complications associated with tissue expander breast reconstruction. BMI ≥ 24 kg/m2 was the only risk factor significantly associated with complications. Clinically, BMI ≥ 24 kg/m2, rather than the standard definition of obesity (BMI > 30 kg/m2), may be a more suitable cutoff point for risk in patients of Asian ethnicity.

AB - Background/Purpose Breast cancer patients in Asia show considerable disparities from Caucasian patients, such as younger age of onset and lower rates of smoking, obesity, and diabetes. Findings of prior studies regarding risk factors associated with complications in tissue expander may not hold for Asian populations, since most of these studies involved Caucasian patients. In this study, we surveyed risk factors in the Taiwanese population, providing additional evidence about the important differences and discuss the implications for clinical practice. Methods Patients who underwent immediate, two-stage, tissue expander breast reconstruction from December 2008 to August 2014 in the National Taiwan University Hospital, Taipei, Taiwan were included. Follow-up observations of all patients were conducted until December 2014. Complications occurring during the tissue expander stage were evaluated. Multivariate regression modeling was used to identify risk factors for complications. Results A total of 246 consecutive, immediate, smooth round tissue expander placements were performed for breast reconstruction. The most common complication was skin necrosis (4.9%), followed by wound dehiscence (4.1%). In the multivariate model, body mass index (BMI) ≥ 24 kg/m2 was the only risk factor that reached statistical significance (odds ratio: 2.41, 95% confidence interval: 1.17–4.96). Conclusion We provided evidence that racial disparities have an impact on the risk factors for complications associated with tissue expander breast reconstruction. BMI ≥ 24 kg/m2 was the only risk factor significantly associated with complications. Clinically, BMI ≥ 24 kg/m2, rather than the standard definition of obesity (BMI > 30 kg/m2), may be a more suitable cutoff point for risk in patients of Asian ethnicity.

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