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乳房重建术后一年的临床及患者报告结局中的种族和民族差异。

Racial and ethnic variations in one-year clinical and patient-reported outcomes following breast reconstruction.

作者信息

Berlin Nicholas L, Momoh Adeyiza O, Qi Ji, Hamill Jennifer B, Kim Hyungjin M, Pusic Andrea L, Wilkins Edwin G

机构信息

Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA.

Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI, USA.

出版信息

Am J Surg. 2017 Aug;214(2):312-317. doi: 10.1016/j.amjsurg.2017.02.009. Epub 2017 Feb 9.

Abstract

BACKGROUND

Existing studies evaluating racial and ethnic disparities focus on describing differences in procedure type and the proportion of women who undergo reconstruction following mastectomy. This study seeks to examine racial and ethnic variations in clinical and patient-reported outcomes (PROs) following breast reconstruction.

METHODS

The Mastectomy Reconstruction Outcomes Consortium is an 11 center, prospective cohort study collecting clinical and PROs following autologous and implant-based breast reconstruction. Mixed-effects regression models, weighted to adjust for non-response, were performed to evaluate outcomes at one-year postoperatively.

RESULTS

The cohort included 2703 women who underwent breast reconstruction. In multivariable models, Hispanic or Latina patients were less likely to experience any complications and major complications. Black or African-American women reported greater improvements in psychosocial and sexual well-being.

CONCLUSIONS

Despite differences in pertinent clinical and socioeconomic variables, racial and ethnic minorities experienced equivalent or better outcomes. These findings provide reassurance in the context of numerous racial and ethnic health disparities and build upon our understanding of the delivery of surgical care to women with or at risk for developing breast cancer.

摘要

背景

现有评估种族和民族差异的研究主要集中在描述手术类型的差异以及乳房切除术后接受重建的女性比例。本研究旨在探讨乳房重建术后临床和患者报告结局(PROs)的种族和民族差异。

方法

乳房切除重建结局联盟是一项由11个中心开展的前瞻性队列研究,收集自体和植入式乳房重建后的临床和PROs数据。采用混合效应回归模型,并进行加权以调整无应答情况,对术后一年的结局进行评估。

结果

该队列包括2703名接受乳房重建的女性。在多变量模型中,西班牙裔或拉丁裔患者发生任何并发症和严重并发症的可能性较小。黑人或非裔美国女性报告在心理社会和性健康方面有更大改善。

结论

尽管在相关临床和社会经济变量方面存在差异,但少数种族和民族的患者结局相当或更好。这些发现为众多种族和民族健康差异提供了慰藉,并增进了我们对为患有乳腺癌或有患乳腺癌风险的女性提供手术治疗的理解。

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