Predictive Risk Factors for Childbirth-Associated Breast Infections in the United States: A 10-Year Perspective.

Infectious mastitis is a common condition that affects up to 33% of lactating women. Several risk factors have been suggested to be strongly associated with breast abscess, nipple infection, and non-purulent mastitis associated with childbirth. In this retrospective cohort study, we gathered data from the National Inpatient Sample (NIS) between 2005 and 2014 and utilized data stratification and backward linear regression to analyze the predictive factors associated with patients hospitalized with breast infection after childbirth, with special consideration of risk factors affecting hospital length of stay (LOS). In the ten-year period, 4614 women were hospitalized with a primary diagnosis of breast abscess, nipple infection, or non-purulent mastitis associated with childbirth. Mean (SD) age was 26.75 (6) years. The highest frequency distribution of cases was observed in patients aged 22-30 years (49.82%). Mean (SD) LOS was 2.83 (1.95) days. Mean (SD) LOS in patients with procedure was 3.53 (2.47) days, which was significantly longer than that in those with no procedure (2.39 (1.36) days, p < 0.001). Primary diagnosis of breast abscess and occurrence of a hospital procedure were most significantly associated with prolonged LOS. Factors such as age, socioeconomic position, severity of functional loss, as well as comorbidities were also contributing risk factors to the development of breast infection and increased hospital LOS. Further studies should examine these findings, as they relate to breastfeeding practices and concentrate on establishing best practices for risk reduction and prevention of childbirth-associated breast and nipple infections and hospitalizations.

Predictive Factors for Surgical Site Infections in Patients Undergoing Surgery for Breast Carcinoma.

INTRODUCTION: Operative interventions for breast cancer are generally classified as clean surgeries. Surgical site infections (SSIs), while rare, do occur. This study sought to identify risk factors for SSI, using the National Surgical Quality Improvement Program (NSQIP). METHODS: NSQIP's participant use data files (PUF) between 2012 and 2015 were examined. Female patients with invasive breast cancer who underwent surgery were identified through CPT and ICD9 codes. Non-SSI and SSI groups were compared and the statistical differences were addressed through propensity score weighting. Multivariate logistic regression testing was used to identify predictors of SSI. RESULTS: This study examined 30 544 lumpectomies and 23 494 mastectomies. SSI rate was 1126/54 038 patients (2.1%). In the weighted dataset, mastectomy, diabetes, smoking, COPD, ASA class-severe, BMI >35 kg/m2, and length of stay (LOS) >1 day were associated with an increased odds ratio (OR) of SSI. The OR for SSI was highest after mastectomy with reconstruction (OR 2.626, P < .001; 95% CI 2.073-3.325). Postoperative variables associated with an increased OR of SSIs included systemic infection, unplanned reoperation wound dehiscence, and renal failure. CONCLUSION: Mastectomy, diabetes, smoking, COPD, ASA class-severe, BMI >35 kg/m2, length of stay (LOS) >1 day are associated with an increased OR for SSIs following breast surgery.