47. Does Ketorolac Increase Hematoma Risk in Breast Reduction? A Propensity-Score Matched Analysis

PURPOSE: Ketorolac is a potent analgesic used to alleviate postoperative pain; however, its use is limited given concern for a possible increase in postoperative bleeding and hematoma formation. Prior studies investigating this question have been limited in sample size. Therefore, this study utilizes a large database to investigate whether ketorolac administration increases postoperative complication rates in breast reduction patients. METHODS: The TriNetX electronic health database was queried in October 2024 for patients who had undergone breast reduction. Patients were stratified by treatment with or without ketorolac. Patients were 1:1 propensity score matched based on age, demographics and comorbidities. Risk ratios and p-values were calculated for the primary outcome of hematoma rate at postoperative day 30. RESULTS: In total 7,408 patients were propensity score matched in each group. Breast reduction patients who received ketorolac had a significantly higher rate of hematoma compared to those who did not receive ketorolac (1.39% vs. 0.72%, respectively, p<0.0001). Rate of hematoma/seroma evacuation was also significantly higher in those administered ketorolac (2.01% vs. 1.46%, p=0.01). No differences were found in seroma, transfusion, or hospitalization rates between groups. CONCLUSION: Ketorolac administration intra- or post-operatively was associated with an increased risk of hematoma and hematoma/seroma evacuation in this cohort of breast reduction patients. Further research should evaluate the impact of ketorolac on other breast procedures to better characterize its effects.