{
  "abstract": "Introduction Mastectomy is often used as a primary treatment for breast cancer or as a preventive measure for at-risk groups. An estimated 275,000 women underwent implantable cardioverter-defibrillator(ICD) insertion procedures over the past decade. At present, there are no studies investigating women with prior mastectomy who underwent ICD implantations. We aim to evaluate the differences in comorbidities, demographics, and complications among females with and without prior mastectomy who received ICD devices.Methods Our retrospective study, through the National Inpatient Sample, consisted of females who underwent ICD implantation in the United States between 2016 and 2021. Our sample was divided into patients who had a prior mastectomy and those who did not. Demographic variables such as age, race, insurance form, hospital status, and multiple comorbidities between our two groups were compared. Multivariable regression models were employed to calculate the adjusted odds ratio(aOR) of complications between them.Results Of the 53300 procedures of ICD implantation, 895(1.7%) previously had a mastectomy. Cases with prior mastectomy were older (median age 70.0 vs. 64.0 years, p<0.01), with a higher prevalence of dyslipidemia(56.4% vs. 50.0%, p<0.01), history of malignancy(86.6% vs. 7.9%, p<0.01), and CHF(85.5% vs. 79.8%, p<0.01), while having fewer cases with diabetes (32.4% vs. 37.4%, p<0.01), prior CABG(6.1% vs. 8.8%,p<0.01), prior PCI (9.5% vs. 13.3%, p<0.01), liver cirrhosis (4.5% vs. 6.2%, p=0.029), coagulopathy(4.5% vs. 8.2%, p<0.01), obesity (19.0% vs. 24.9%, p<0.01), and COPD(21.8% vs. 28.0%, p<0.01). They also demonstrated lower odds of several cardiac dysrhythmias, including atrial fibrillation, supraventricular tachycardia, ventricular tachycardia, and events of acute ischemic stroke(AIS) or acute kidney injury(AKI). However, no significant differences were observed in other complications, including pleural drainage, major bleeding, pericardial effusion, postprocedural pneumothorax, cardiogenic shock, vasopressor use, or sepsis ( table 1). The mastectomy group had a shorter stay(median stay 5.0 vs. 6.0 days, p<0.01) at a lower inflation-adjusted hospital cost($44115 vs. $47908, p<0.01).Conclusion To date, this is the first study analyzing the implantations of ICD among women with mastectomy. While the lower odds of cardiac dysrhythmias, AIS, and AKI may correlate with their more strict pre- and post-procedural monitoring, further studies are warranted.Abstract 4-018 Table 1 Complications p-value AOR Lower 95% CI Upper 95% CI Post proc pneumothorax 0.065 1.605 0.97 2.655 Sepsis 0.84 0.96 0.648 1.422 Major bleeding 0.533 0.948 0.803 1.12 Cardiogenic shock 0.186 0.795 0.566 1.117 Ventricular tachycardia 0.031 0.85 0.733 0.985 Atrial fibrillation <.001 0.592 0.502 0.699 Supraventricular tachycardia <.001 0.405 0.277 0.591 Acute ischemic stroke 0.019 0.339 0.137 0.84 Acute myocardial infarction 0.053 0.789 0.621 1.003 Acute kidney injury <.001 0.702 0.574 0.859",
  "authors": [
    {
      "affiliations": [
        "Royal Wolverhampton NHS Trust, Wolverhampton, UK"
      ],
      "name": "Gabriel Imbianozor"
    },
    {
      "affiliations": [
        "Trinity Health Oakland/Wayne State University, Michigan, USA"
      ],
      "name": "Fathima Ayoobkhan"
    },
    {
      "affiliations": [
        "Trinity Health Oakland/Wayne State University, Michigan, USA"
      ],
      "name": "Vivek Mittal"
    },
    {
      "affiliations": [
        "Lancaster University, Lancaster, UK"
      ],
      "name": "Affan Nabeel"
    },
    {
      "affiliations": [
        "Trinity Health Oakland/Wayne State University, Michigan, USA"
      ],
      "name": "Quang Dat Ha"
    },
    {
      "affiliations": [
        "Trinity Health Oakland/Wayne State University, Michigan, USA"
      ],
      "name": "Christian Gahona"
    },
    {
      "affiliations": [
        "DMC/WSU (Sinai-Grace) Hospital, Detroit, Michigan, USA"
      ],
      "name": "Nomesh Kumar"
    },
    {
      "affiliations": [
        "Trinity Health Livonia Hospital, Livonia, Michigan, USA"
      ],
      "name": "Parampreet Johal"
    },
    {
      "affiliations": [
        "Overland Park Regional Medical Center, Kansas, USA"
      ],
      "name": "Rutvi Amin"
    },
    {
      "affiliations": [
        "St. Michael Hospital, Texarkana, Texas, USA"
      ],
      "name": "Hemamalini Sakthivel Christus"
    },
    {
      "affiliations": [
        "Independent Researcher, Triolet, Mauritius"
      ],
      "name": "Kamleshun Ramphul"
    },
    {
      "affiliations": [
        "National Heart and Lung Institute, Imperial College London, London, UK"
      ],
      "name": "Raheel Ahmed"
    }
  ],
  "title": "4-018 Evaluating the baseline characteristics, comorbidities, and outcomes of females with prior mastectomy undergoing implantable cardioverter-defibrillator implantation in the United States",
  "uid": "c1bb477b-f9b4-5b07-bfcb-59d26fc1fbb4"
}