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Key Determinants Of Immediate Vs. Delayed Diagnosis In Trauma-related Breast Implant Complications: Insights From The Nationwide Readmission Database
Jade E. Smith, BA1, Noelle C. Garbaccio, BSc
1, Dorien I. Schonebaum, BSc
1, Lacey Foster, BSc
1, Morvarid Mehdizadeh, BA
1, Justin J. Cordero, BSc
1, Jose Foppiani, MD
2, Henry Marsh, MD
2, Umar Choudry, MD
2, Samuel J. Lin, MD, MBA
1.
1Beth Israel Deaconess Medical Center, Boston, MA, USA, 2Department of Plastic and Reconstructive Surgery, University of Minnesota, Minneapolis, MN, USA.
PURPOSE: Post-traumatic breast implant complications are underexplored, and implant-related complications can mimic or obscure other trauma-related conditions, delaying care. This study uses the Nationwide Readmission Database (NRD) to explore factors influencing diagnosis timing to improve early detection and management.
METHODS: The NRD (2017-2020) was queried for post-traumatic breast implant complications. Eligible cases included admissions with a new trauma ICD-10 code preceding or accompanying a new implant complication. Immediate diagnoses were defined as an implant complication (e.g., rupture, displacement) or surgery during trauma admission. Delayed diagnoses were captured through readmissions. Chi-square and cox regression identified predictors of earlier diagnosis.
RESULTS: Of 573 patients, 78.2% had complications identified immediately, and 35.4% underwent breast surgery during the trauma visit. For delayed diagnoses, the median time to diagnosis or procedure was 75 days (IQR = 26-138). Transportation incidents were associated with earlier diagnoses compared to falls, burns, and contact with animals. Rib fractures (HR = 1.499, p < .001) and breast pain on admission (HR = 1.735, p = .044) predicted earlier diagnosis. Plastic surgery consults during trauma admission led to significantly earlier procedures (Z = -3.975, p < .001).
CONCLUSION: Mechanism of injury, rib fractures, and documented breast pain significantly influence the timing of post-traumatic breast implant diagnoses. Plastic surgery consults improve intervention timing, emphasizing the need for early specialist involvement and thorough breast examination in trauma cases.
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