Oral and Maxillofacial Surgery Complication Rates at a Major Teaching Hospital: A 9-Year Retrospective Review

Abstract

Background

Postoperative complications in oral and maxillofacial surgery (OMS) can prolong recovery, increase health care costs, and negatively impact patient outcomes. Identifying complication trends is crucial for improving patient care and safety, particularly in academic settings where balancing surgical training and patient safety is essential.

Purpose

The study purpose is to measure and identify trends in the prevalence of OMS complications over a 9-year period at a major teaching hospital.

Study Design, Setting, Sample

This retrospective cohort study was conducted at Memorial Hermann Hospital, Texas Medical Center, Houston. The study included 4,466 documented operations performed between July 1, 2014, and June 30, 2023, with no exclusions.

Predictor Variable

The primary predictor variable was date of surgery, measured in years. A secondary predictor variable was procedure type, categorized into 8 groups: trauma, infection, dentoalveolar, reconstruction, pathology, critical care, orthognathic, and temporomandibular joint disorder.

Main Outcome Variable

The primary outcome variable was the occurrence of postoperative complications, defined as any adverse outcome or unintended consequence resulting from medical or surgical treatment and documented as a morbidity or mortality event. A secondary outcome variable was complication type.

Covariates

Age and sex associated with procedures were collected.

Analyses

Demographic variables were computed at the subject level. Descriptive analysis at the procedure level was used to calculate the prevalence of complications. A generalized linear model assessed trends in complication prevalence, procedure volume, and complication type over time, while Fisher’s exact test examined the relationship between procedure type and complication type. A P value of <.05 was considered statistically significant.

Results

The sample was composed of 4,466 operations and 4,453 subjects with a mean age of 41.4 (±4.6) and 2,724 (61%) were male. There were 325 (7.28%) complications. There was no statistically significant trend in the prevalence of complications over time (B-coefficient 0.002, 95% CI −3.9 to 0.004, P = .1). There was a significant association between procedure type and complication type (P < .001). Orthognathic procedures exhibited the highest proportion of complications at 17.4% (n = 4), while critical care procedures demonstrated the lowest at 2.0% (n = 4).

Conclusion and Relevance

No statistically significant trend in the prevalence of complications was observed, but procedure type was associated with complication type.