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National trends and outcomes of same-day discharge after direct-to-implant breast reconstruction: a 15-year NSQIP analysis

Background - Same-day discharge following direct-to-implant (DTI) breast reconstruction is increasingly common; however, large-scale outcome studies are scarce. This study evaluated the trends and postoperative outcomes in patients who were discharged on the same day following DTI. - Methods - We an...

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Main Authors: Kauke-Navarro, Martin (Author) , Knoedler, Samuel (Author) , Klimitz, Felix J. (Author) , Lizardi, Juan (Author) , Allam, Omar (Author) , Diatta, Fortunay (Author) , Gala, Zachary (Author) , Berger, Elizabeth (Author) , Schaschinger, Thomas (Author) , Wirtz, Julius M. (Author) , Milacak, Zvjezdana (Author) , Broer, P. Niclas (Author) , Haykal, Siba (Author) , Pomahac, Bohdan (Author)
Format: Article (Journal)
Language:English
Published: November 2025
In: Journal of plastic, reconstructive & aesthetic surgery
Year: 2025, Volume: 110, Pages: 147-155
ISSN:1878-0539
DOI:10.1016/j.bjps.2025.09.002
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.bjps.2025.09.002
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1748681525005352
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Author Notes:Martin Kauke-Navarro, Samuel Knoedler, Felix J. Klimitz, Juan Lizardi, Omar Allam, Fortunay Diatta, Zachary Gala, Elizabeth Berger, Thomas Schaschinger, Julius M. Wirtz, Zvjezdana Milacak, P. Niclas Broer, Siba Haykal, Bohdan Pomahac
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Summary:Background - Same-day discharge following direct-to-implant (DTI) breast reconstruction is increasingly common; however, large-scale outcome studies are scarce. This study evaluated the trends and postoperative outcomes in patients who were discharged on the same day following DTI. - Methods - We analyzed female patients with breast cancer who underwent DTI breast reconstruction from 2008-2023 using their data from the National Surgical Quality Improvement Program database. Patients were grouped by length of stay (LOS = 0 days (no overnight stay) vs. LOS > 0 days (with overnight stay)). Primary outcomes included 30-day surgical and medical complications, reoperations, and readmissions. Propensity score matching and inverse probability of treatment weighting were used to adjust for baseline differences between the 2 cohorts. - Results - Among 11,505 cases, 2457 (21.4%) patients were discharged the same day. Compared to inpatients, same-day discharge patients were on an average younger (mean age 51.2 vs. 53.4 years, p < 0.001) and had lower BMI (mean 26.9 vs. 28.1 kg/m2, p < 0.001). After statistical adjustment for baseline patient differences, same-day discharge was associated with lower odds of any complication (OR 0.79, 95% CI 0.72-0.87, p < 0.001), reoperation (OR 0.72, 95% CI 0.63-0.82, p < 0.001), and readmission (OR 0.70, 95% CI 0.61-0.81, p < 0.001). There was no increase in surgical or medical complications in the same day discharge cohort. - Conclusions - Same-day discharge after DTI breast reconstruction was safe, with no increase in short-term complications, among appropriately selected patients based on clinical and demographic factors. These findings support same day discharge after DTI in selected patients.
Item Description:Gesehen am 23.03.2026
Physical Description:Online Resource
ISSN:1878-0539
DOI:10.1016/j.bjps.2025.09.002

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