Table 3. Mixed-Effects Logistic Regression Model for 2-Year Postoperative Complications.
| Variable | Any Complication | Reoperative Complication | Wound Infection | |||
|---|---|---|---|---|---|---|
| OR (95% CI) | P Value | OR (95% CI) | P Value | OR (95% CI) | P Value | |
| Age | 1.02 (1.01-1.03) | .004 | 1.02 (1.01-1.03) | .003 | 1.01 (1.00-1.03) | .10 |
| BMI | 1.05 (1.03-1.07) | <.001 | 1.04 (1.02-1.07) | <.001 | 1.07 (1.05-1.10) | <.001 |
| Procedure type | ||||||
| EI technique | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| DTI technique | 1.08 (0.65-1.77) | .78 | 1.06 (0.56-1.99) | .87 | 1.70 (0.91-3.18) | .10 |
| pTRAM flap | 1.91 (1.10-3.31) | .02 | 2.48 (1.33-4.64) | .005 | 0.73 (0.31-1.70) | .46 |
| fTRAM flap | 2.05 (1.24-3.40) | .005 | 3.02 (1.73-5.29) | <.001 | 0.45 (0.17-1.18) | .10 |
| DIEP flap | 1.97 (1.41-2.76) | <.001 | 2.76 (1.87-4.07) | <.001 | 0.44 (0.25-0.78) | .005 |
| LD flap | 1.87 (1.03-3.40) | .04 | 1.03 (0.46-2.29) | .94 | 0.50 (0.16-1.56) | .23 |
| SIEA flap | 4.71 (2.32-9.54) | <.001 | 2.62 (1.24-5.53) | .01 | 0.67 (0.25-1.82) | .43 |
| Timing | ||||||
| Immediate | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Delayed | 0.55 (0.34-0.89) | .02 | 0.71 (0.40-1.25) | .23 | 0.76 (0.33-1.71) | .50 |
| Laterality | ||||||
| Unilateral | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Bilateral | 1.50 (1.20-1.86) | <.001 | 1.52 (1.17-1.97) | .002 | 1.27 (0.91-1.76) | .16 |
| Indication | ||||||
| Therapeutic | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Prophylactic | 0.89 (0.59-1.32) | .55 | 1.18 (0.73-1.90) | .50 | 0.66 (0.35-1.27) | .22 |
| Lymph node management | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| SLNB | 0.82 (0.60-1.12) | .21 | 1.04 (0.71-1.53) | .83 | 0.79 (0.49-1.28) | .34 |
| ALND | 0.84 (0.58-1.22) | .36 | 1.10 (0.71-1.71) | .68 | 0.58 (0.33-1.01) | .056 |
| Diabetes | 1.08 (0.66-1.78) | .75 | 1.40 (0.81-2.42) | .22 | 1.09 (0.53-2.23) | .81 |
| Smoking status | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Previous | 1.12 (0.91-1.38) | .29 | 1.23 (0.96-1.57) | .11 | 0.94 (0.68-1.30) | .71 |
| Current | 1.92 (1.09-3.40) | .02 | 2.06 (1.10-3.86) | .02 | 0.79 (0.30-2.12) | .64 |
| Radiotherapy | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Before reconstruction | 1.05 (0.73-1.50) | .80 | 0.78 (0.50-1.20) | .26 | 1.67 (0.96-2.89) | .07 |
| During or after reconstruction | 1.99 (1.46-2.69) | <.001 | 1.96 (1.38-2.78) | <.001 | 2.77 (1.78-4.31) | <.001 |
| Chemotherapy | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Neoadjuvant | 0.88 (0.63-1.21) | .42 | 1.03 (0.70-1.51) | .90 | 0.77 (0.47-1.27) | .31 |
| Adjuvant | 1.05 (0.80-1.37) | .74 | 1.36 (0.98-1.87) | .06 | 1.03 (0.68-1.55) | .89 |
| Neoadjuvant and adjuvant | 1.50 (0.83-2.72) | .18 | 2.41 (1.28-4.51) | .006 | 0.80 (0.31-2.06) | .64 |
| Race | ||||||
| White | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Black | 0.77 (0.50-1.18) | .23 | 0.73 (0.44-1.22) | .23 | 0.74 (0.37-1.48) | .40 |
| Other | 1.07 (0.69-1.66) | .77 | 0.58 (0.31-1.08) | .09 | 1.14 (0.58-2.25) | .70 |
| Ethnicity | ||||||
| Non-Hispanic or Latino | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Hispanic or Latino | 0.66 (0.40-1.10) | .11 | 0.62 (0.32-1.19) | .15 | 0.72 (0.32-1.63) | .43 |
| Income, $ | ||||||
| ≥100 000 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| <50 000 | 1.06 (0.77-1.46) | .71 | 1.17 (0.80-1.69) | .42 | 0.70 (0.42-1.16) | .17 |
| 50 000-99 000 | 1.10 (0.87-1.39) | .42 | 1.25 (0.95-1.65) | .12 | 0.97 (0.68-1.39) | .88 |
| Educational level | ||||||
| High school or less | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Some college | 0.97 (0.66-1.41) | .86 | 1.42 (0.91-2.21) | .12 | 1.16 (0.62-2.16) | .64 |
| College degree | 0.89 (0.63-1.26) | .51 | 1.22 (0.80-1.84) | .35 | 1.28 (0.73-2.25) | .39 |
| Master’s or doctoral degree | 0.88 (0.60-1.29) | .51 | 1.06 (0.67-1.68) | .81 | 1.10 (0.60-2.03) | .76 |
| Marital status | ||||||
| Not married or partnered | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Married or partnered | 0.98 (0.76-1.27) | .90 | 1.03 (0.76-1.39) | .86 | 1.09 (0.73-1.64) | .67 |
| Employment status | ||||||
| Unemployed | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Full time (including student) | 1.01 (0.80-1.28) | .94 | 1.08 (0.82-1.43) | .58 | 1.09 (0.75-1.57) | .66 |
| Part time | 1.10 (0.80-1.51) | .56 | 1.04 (0.71-1.52) | .84 | 1.64 (1.03-2.60) | .04 |
Abbreviations: ALND, axillary lymph node dissection; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); DIEP, deep inferior epigastric perforator; DTI, direct to implant; EI, expander implant; fTRAM, free transverse rectus abdominis myocutaneous; LD, latissimus dorsi; NA, not applicable; OR, odds ratio; pTRAM, pedicled transverse rectus abdominis myocutaneous; SIEA, superficial inferior epigastric artery perforator; SLNB, sentinel lymph node biopsy.