Abstract：
BACKGROUND: Orthognathic surgery (OS) is a frequently performed procedure for the correction of dentofacial deformities and malocclusion. Research on OS is mostly limited to single-surgeon experience or single-institutional reports. We, therefore, retrospectively analyzed a multi-institutional database to investigate outcomes of OS and identify risk factors for peri- and postoperative complications.
METHODS: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008-2020) to identify patients who underwent OS for mandibular and maxillary hypo- and hyperplasia. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. We also evaluated risk factors for complications.
RESULTS: The study population included 674 patients, 48% of whom underwent single jaw surgery, 40% double jaw surgery, and 5.5% triple jaw surgery. The average age was 29 ± 11 years, with an equal gender distribution (females: n = 336; 50%, males: n = 338; 50%). Adverse events were relatively rare, with a total of 29 (4.3%) complications reported. The most common surgical complication was superficial incisional infection (n = 14; 2.1%). While the multivariable analysis revealed isolated single lower jaw surgery (p = 0.03) to be independently associated with surgical complication occurrence, it also identified an association between the outpatient setting and the frequency of surgical complications (p = 0.03) and readmissions (p = 0.02). In addition, Asian ethnicity was identified as a risk factor for bleeding (p = 0.003) and readmission (p = 0.0009).
CONCLUSIONS: Based on the information recorded by the ACS-NSQIP database, our analysis underscored the positive (short-term) safety profile of OS. We found OS of the mandible to be associated with higher complication rates. The calculated risk role of OS in the outpatient setting warrants further investigation. A significant correlation between Asian OS patients and postoperative adverse events was found. Implementation of these novel risk factors into the surgical workflow may help facial surgeons refine their patient selection and improve patient outcomes. Future studies are needed to investigate the causal relationships of the observed statistical correlations.
METHODS: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008-2020) to identify patients who underwent OS for mandibular and maxillary hypo- and hyperplasia. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. We also evaluated risk factors for complications.
RESULTS: The study population included 674 patients, 48% of whom underwent single jaw surgery, 40% double jaw surgery, and 5.5% triple jaw surgery. The average age was 29 ± 11 years, with an equal gender distribution (females: n = 336; 50%, males: n = 338; 50%). Adverse events were relatively rare, with a total of 29 (4.3%) complications reported. The most common surgical complication was superficial incisional infection (n = 14; 2.1%). While the multivariable analysis revealed isolated single lower jaw surgery (p = 0.03) to be independently associated with surgical complication occurrence, it also identified an association between the outpatient setting and the frequency of surgical complications (p = 0.03) and readmissions (p = 0.02). In addition, Asian ethnicity was identified as a risk factor for bleeding (p = 0.003) and readmission (p = 0.0009).
CONCLUSIONS: Based on the information recorded by the ACS-NSQIP database, our analysis underscored the positive (short-term) safety profile of OS. We found OS of the mandible to be associated with higher complication rates. The calculated risk role of OS in the outpatient setting warrants further investigation. A significant correlation between Asian OS patients and postoperative adverse events was found. Implementation of these novel risk factors into the surgical workflow may help facial surgeons refine their patient selection and improve patient outcomes. Future studies are needed to investigate the causal relationships of the observed statistical correlations.
摘要：
背景：正颌手术（OS）是一种经常进行的用于矫正牙面畸形和错牙合的手术。对OS的研究主要限于单外科医生经验或单机构报告。我们,因此,回顾性分析多机构数据库,以调查OS的结局,并确定围手术期和术后并发症的危险因素.
方法：我们回顾了美国外科医生学会国家外科质量改进计划（ACS-NSQIP）数据库（2008-2020），以确定因下颌骨和上颌骨发育不良和增生而接受OS的患者。感兴趣的术后结果包括30天的手术和内科并发症，再操作,重新接纳,和死亡率。我们还评估了并发症的危险因素。
结果：研究人群包括674名患者，48%的人接受了单颌手术，40%双颌手术，和5.5%的三颌手术。平均年龄29±11岁,性别分布相等(女性：n=336；50%，男性：n=338；50%）。不良事件相对罕见，共报告29例(4.3%)并发症。最常见的手术并发症是浅表切口感染（n=14；2.1％）。虽然多变量分析显示孤立的单颌手术（p=0.03）与手术并发症的发生独立相关，它还确定了门诊设置与手术并发症频率(p=0.03)和再入院(p=0.02)之间的关联.此外,亚洲种族被确定为出血（p=0.003）和再入院（p=0.0009）的危险因素。
结论：根据ACS-NSQIP数据库记录的信息，我们的分析强调了OS的积极(短期)安全性.我们发现下颌骨的OS与较高的并发症发生率有关。OS在门诊环境中的风险作用值得进一步调查。发现亚洲OS患者与术后不良事件之间存在显着相关性。将这些新的风险因素实施到手术工作流程中可以帮助面部外科医生改进他们的患者选择并改善患者结果。未来的研究需要调查观察到的统计相关性的因果关系。
方法：我们回顾了美国外科医生学会国家外科质量改进计划（ACS-NSQIP）数据库（2008-2020），以确定因下颌骨和上颌骨发育不良和增生而接受OS的患者。
结果：研究人群包括674名患者，
结论：根据ACS-NSQIP数据库记录的信息，
