Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Jan 13:22925503251411906.
doi: 10.1177/22925503251411906. Online ahead of print.

Unplanned Emergency Department Visits Within 90 Days of Breast Reduction Surgery: A Retrospective Cohort Study

Olivia C MacIntyre  1 , Tamara D Selman  2 , Jo-Anne Douglas  3 , Evan Nemeth  4 , Julia M Harrison  2 , Margaret E Wheelock  2   5 , Emily M Krauss  2
Affiliations

Unplanned Emergency Department Visits Within 90 Days of Breast Reduction Surgery: A Retrospective Cohort Study

Olivia C MacIntyre et al. Plast Surg (Oakv). .

Abstract
in English, French

Introduction: Emergency departments (EDs) have been under substantial strain in recent years, far exceeding current capacities and attracting media attention and calls for improved staffing and resources. A portion of patients presenting to EDs include postoperative patients. We sought to identify the proportion of patient presenting postoperatively to the ED after common plastic surgery elective procedures to identify target populations and presentations for diversion from the ED. This study investigates the incidence and etiology of postoperative ED presentations in the bilateral reduction mammoplasty (BBR) population, the most common general anesthetic plastic surgery procedure in our jurisdiction. Methods: This retrospective healthcare-utilization study collected all ED visits across a single province from April 2016 to March 2022 within 90 days postoperatively from BBR. Visit timing, frequency, chief complaint, diagnosis, and discharge destination from ED were recorded and analyzed for relationships to the index surgery and for predictable patterns. Results: Of the 452 patients who underwent bilateral breast reduction mammoplasty between 2016 and 2022, 75 (16.6%) patients presented to the ED within 90-day postoperatively. Of these 75 patients, 49 were directly related to the primary surgery (10.8% surgical ED return rate) for complaints of surgical site infection (36.7%), pain (30.6%), wound check (22.4%), swelling (20.4%), and bleeding (20.4%). Conclusion: After routine reduction mammoplasty, 10.8% of patients presented to the ED for surgery-specific concerns. This study describes targets to assist in diverting routine postoperative visits from the ED back toward the surgeon's office. Enhanced patient education, improved follow-up infrastructure, and pain control education are possible areas for intervention.

Introduction : Les urgences ont été soumises à de fortes pressions ces dernières années, qui dépassent largement les capacités actuelles, attirent l’attention des médias et nécessitent une amélioration de la dotation en personnel et des ressources. Une partie des patients qui consultent à l’urgence ont subi une opération récente. Les chercheurs souhaitaient établir quelle proportion de patients consultait à l’urgence après des interventions courantes et non urgentes en chirurgie plastique afin de déterminer les populations cibles à détourner de l’urgence. La présente étude a porté sur l’incidence et l’étiologie des consultations postopératoires à l’urgence parmi la population des personnes qui ont subi une réduction mammaire bilatérale (RMB), l’intervention de chirurgie plastique en anesthésie générale la plus courante de la région sociosanitaire. Méthodologie : La présente étude rétrospective d’utilisation du système de santé a permis de recueillir toutes les consultations à l’urgence dans une seule province entre avril 2016 et mars 2022 dans les 90 jours suivant une RMB. Les chercheurs ont analysé le moment et la fréquence des consultations, la principale doléance, le diagnostic et la destination du congé de l’urgence pour établir les relations avec l’opération de référence et les profils prévisibles. Résultats : Des 452 patientes qui ont subi une réduction mammaire bilatérale entre 2016 et 2022, 75 (16,6%) ont consulté à l’urgence dans les 90 jours suivant l’opération. Chez ces 75 patientes, 49 des consultations étaient directement reliées à l’opération primaire (10,8% de taux de retour à l’urgence à cause de l’opération) à cause d’une infection au foyer de l’opération (36,7%), de douleur (30,6%), d’une vérification de la plaie (22,4%), d’un œdème (20,4%) ou de saignements (20,4%). Conclusion : Après une réduction mammaire courante, 10,8% des patientes consultent à l’urgence en raison de préoccupations liées à l’opération. Cette étude décrit les cibles pour contribuer à réorienter les consultations postopératoires à l’urgence vers le cabinet de chirurgie. Une meilleure éducation des patients, une meilleure infrastructure de suivi et de l’éducation sur le contrôle de la douleur font partie des secteurs possibles d’intervention.

Keywords: emergency department; healthcare utilization; quality improvement; reduction mammoplasty; resource management.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Consort Diagram of Postoperative Emergency Department Visit Selection.
Figure 2.
Figure 2.
Emergency Department Visit Frequency by Day Following Breast Reduction Mammoplasty.
Figure 3.
Figure 3.
Total Number of Patients Presenting to the Emergency Department for Medical or Surgical Reasons Following Bilateral Reduction Mammoplasty Within 90 Days.
Figure 4.
Figure 4.
Reason for Post–Breast Reduction Presentation to the Emergency Department by Diagnosis as a Percentage of Total Reasons for Presentation.
Figure 5.
Figure 5.
Driver Diagram of Current Initiatives to Reduce Postoperative Unplanned Emergency Department Visits.
See this image and copyright information in PMC

References

    1. Emergency Department Wait Times. Nova Scotia Health. Accessed October 17, 2024. https://www.nshealth.ca/emergency-care/emergency-department-wait-times.
    1. Hospital Spending. Canadian Institute for Health Information. Accessed October 17, 2024. https://www.cihi.ca/en/hospital-spending.
    1. Marshall EG, Stock D, Buote R, et al. Emergency department utilization and hospital admissions for ambulatory care sensitive conditions among people seeking a primary care provider during the COVID-19 pandemic. Can Med Assoc J Open. 2023;11(3):E527–E536. doi: 10.9778/cmajo.20220128 - DOI - PMC - PubMed
    1. Sugar R, Jansen A, Olson J, McDonald S. The red dot initiative: an analysis of postoperative visits to the emergency department. BC Med J. 2018;60(8):398–402.
    1. ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2023. International Society of Aesthetic Plastic Surgeons. June 12, 2024. Accessed December 5, 2024. https://www.isaps.org/media/rxnfqibn/isaps-global-survey_2023.pdf

LinkOut - more resources