Increasing rates of general anesthesia use in lumpectomy procedures: A 15-year trends analysis Journal Article

   


Authors: Rubenstein, R. N.; Tadros, A.; Slutsky, H. L.; Plotsker, E. L.; Haglich, K.; Stern, C. S.; Morrow, M.; Nelson, J. A.; Nelson, P.
Article Title: Increasing rates of general anesthesia use in lumpectomy procedures: A 15-year trends analysis
Abstract: Background: Anesthesia methods in oncologic breast surgery have evolved with less invasive practices. The aims of this study were primarily to examine trends in anesthesia type used during lumpectomy. Methods: We analyzed lumpectomy procedures from 2005 to 2019 using the NSQIP database. Upon defining the nadir in general anesthesia (GA) and peak in monitored anesthesia care (MAC) use as 2007, we compared patient characteristics and complications in the 2007 versus 2019 GA and MAC cohorts. Multivariable logistic regression was used to examine associations with receipt of GA. Results: Of 253 545 lumpectomy patients, 191 773 (75.6%) received GA and 61 772 (24.4%) received MAC. From 2005 to 2019, GA rates increased from 66.7% to 82.5%, while MAC rates decreased from 33.3% to 17.5%. More GA patients were obese and American Society of Anesthesiologists class 3. Over time, age and body mass index (BMI) increased in both GA and MAC cohorts. Odds of receiving GA increased over time, and predictors included concurrent axillary lymph node dissection (p < 0.0001) or sentinel lymph node biopsy (p < 0.0001). Conclusions: We demonstrate increasing use of GA over time for lumpectomy, which may be related to aging lumpectomy patient population with higher BMIs. We also find a strong association between use of GA and concurrent lymph node procedures. © 2023 Wiley Periodicals LLC.
Keywords: adult; controlled study; aged; retrospective studies; major clinical study; ascites; hypertension; lymph node dissection; lymph nodes; lymph node excision; sentinel lymph node biopsy; cohort analysis; obesity; smoking; steroid; kidney failure; breast neoplasms; retrospective study; dyspnea; pneumonia; lung embolism; postoperative complication; body mass; heart infarction; breast tumor; lymph node; diabetes mellitus; operation duration; partial mastectomy; surgical infection; comorbidity; general anesthesia; anesthesia, general; insulin; hospital patient; sepsis; outpatient; oral antidiabetic agent; congestive heart failure; functional status; mastectomy, segmental; heart arrest; chronic obstructive lung disease; cerebrovascular accident; longitudinal study; lumpectomy; anesthesia; axillary lymph node dissection; lymphangiography; medical history; septic shock; procedures; bleeding disorder; renal replacement therapy; very elderly; humans; human; female; article; obese patient
Journal Title: Journal of Surgical Oncology
Volume: 127
Issue: 7
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2023-06-01
Start Page: 1092
End Page: 1102
Language: English
DOI: 10.1002/jso.27226
PUBMED: 36915277
PROVIDER: scopus
PMCID: PMC10823799
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85150633094&doi=10.1002%2fjso.27226&partnerID=40&md5=8f3bd54a6736df40a554d74bb76708b8
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Audree Tadros -- Export Date: 31 May 2023 -- Source: Scopus
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MSK Authors
  1. Monica Morrow
    772 Morrow
  2. Carrie Stern
    41 Stern
  3. Jonas Allan Nelson
    212 Nelson
  4. Audree Blythe Tadros
    116 Tadros
  5. Robyn Rubenstein
    26 Rubenstein
  6. Hanna Lynn Slutsky
    4 Slutsky
  7. Kathryn Ann Haglich
    27 Haglich
  8. Ethan L. Plotsker
    16 Plotsker
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