小儿正颌外科手术:NSQIP-P:比较裂隙和非裂隙患者的术前因素和结果差异。

IF 1.2 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Cleft Palate-Craniofacial Journal Pub Date : 2024-05-01 Epub Date: 2022-12-21 DOI:10.1177/10556656221145079
Victoria G Zeyl, Christopher D Lopez, Joshua Yoon, Krissia M Rivera Perla, Pasha Shakoori, Alisa O Girard, Elizabeth Hopkins, Richard J Redett, Robin S Yang
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引用次数: 0

摘要

研究目的本研究旨在调查接受单颌(下颌或 LeFort 1)和双颌(BSSO + LeFort 1)手术的唇裂和非唇裂患者的风险因素、并发症概况和临床结果:回顾性横断面研究:2018-2019年国家外科质量改进计划数据库.患者:儿童患者:干预措施:对下颌骨、LeFort 1和双颌截骨术的结果进行回顾性评估:采用多变量逻辑回归法确定接受单颌和双颌手术的唇裂和非唇裂患者出现并发症的几率和住院时间:在研究期间,669名儿童患者接受了正颌手术;大多数患者仅接受了LF1(n = 385;58.3%),其次是仅下颌骨(n = 179;27.1%)和双颌(n = 105;15.9%)。56%的LFI患者、32%的下颌患者和22%的双颌患者存在裂隙差异。经过多变量调整后,ASA III 级患者发生任何并发症(包括再次入院和再次手术)的几率增加了近 400% (OR = 5.99;CI [[1.54-23.32]],P 结论:在不同手术类型中,裂隙和非裂隙患者的并发症发生率仍然较低。小儿正颌手术中最重要的风险因素不是存在裂隙,而是 ASA 分级的提高。虽然裂隙在寻求正颌手术的患者中很常见,但在对其他变量进行调整后,裂隙差异并不会导致额外的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pediatric Orthognathic Surgery: A NSQIP-P Comparison of Peri-Operative Factors and Outcome Differences Between Cleft and Noncleft Patients.

Objective: The present study aimed to investigate the risk factors, complication profiles, and clinical outcomes of cleft and noncleft patients undergoing single jaw (mandibular or LeFort 1) and bimaxillary (BSSO + LeFort 1).

Design: Retrospective Cross-sectional Study Setting: National Surgical Quality Improvement Program database 2018-2019.

Patients: Pediatric patients.

Interventions: Outcomes for mandibular, LeFort 1, and bimaxillary osteotomy were retrospectively evaluated for cleft and noncleft patients.

Main outcome measures: Multivariate logistic regression was used to determine the odds of complications and length of stay for cleft and noncleft patients undergoing single jaw and double jaw surgery.

Results: 669 pediatric patient underwent orthognathic surgery in the study period; the majority received LF1 only (n = 385; 58.3%), followed by mandible only (n = 179; 27.1%), and bimaxillary (n = 105; 15.9%%). Cleft differences were present in 56% of LFI patients, 32% of mandibular patients, and 22% of bimaxillary patients. After multivariate adjustment, ASA class III was associated with nearly 400% increased odds of any complication including readmission and reoperation (OR = 5.99; CI [[1.54-23.32]], p < 0.01, and 65% increased LOS (β-coefficient = 1.65, CI [1.37-1.99], p < 0.01). Presence of cleft was not significantly associated with odds of any complication (p = 0.69) nor increased LOS (p = 0.46) in this population.

Conclusion: Complications remained low between surgery types among cleft and noncleft patients. The most significant risk factor in pediatric orthognathic surgery was not the presence of cleft but rather increased ASA class. Though common in patients seeking orthognathic surgery, cleft differences did not cause additional risk after adjustment for other variables.

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来源期刊
CiteScore
2.70
自引率
36.40%
发文量
215
期刊介绍: The Cleft Palate-Craniofacial Journal (CPCJ) is the premiere peer-reviewed, interdisciplinary, international journal dedicated to current research on etiology, prevention, diagnosis, and treatment in all areas pertaining to craniofacial anomalies. CPCJ reports on basic science and clinical research aimed at better elucidating the pathogenesis, pathology, and optimal methods of treatment of cleft and craniofacial anomalies. The journal strives to foster communication and cooperation among professionals from all specialties.
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