Association of Limited English Proficiency With Completion of the Reconstructive Paradigm in Implant-Based Breast Reconstruction.

BACKGROUND

Limited English proficiency (LEP) has been associated with worse postoperative outcomes and lower follow-up in plastic surgery, although its impact in two-stage implant-based breast reconstruction is not well characterized. This study evaluates the effects of LEP on postoperative outcomes in patients who received tissue expander placement for breast reconstruction.

METHODS

Patients who underwent tissue expander placement for implant-based breast reconstruction were identified within a single urban academic center. LEP was defined as preference for a non-English primary language. Primary outcomes included completion of reconstruction, emergency department (ED) visits, readmissions, and postoperative complications. Multivariable regression models were used to identify independent predictors of ED visits/readmissions, complications, and time to completion of reconstruction (P < .05).

RESULTS

The final cohort included 563 patients over a median (IQR) follow-up period of 18.4 (11.0-28.7) months. The rate of overall completion of breast reconstruction was 87.0%. LEP was identified in 171 (30.4%) patients. Rates of breast reconstruction completion (P = .20), ED visits (P = .82), readmissions (P = .38), and postoperative complications (P = .30) were not significantly different depending on LEP status. In a multivariable linear regression model, LEP status was independently associated with a delay in time from TE placement to completion of breast reconstruction (β: 30.9 days, 95% CI, 8.5-53.3, P = .0070). Mean time to completion was 282 days for patients with LEP and 245 days for non-LEP patients.

CONCLUSION

LEP was associated with a delay in time to completion of reconstruction, suggesting delays in surgical care coordination in patients with limited English proficiency.