Changing Patterns of Hospital Length of Stay After Orthognathic Surgery
Purpose
The purpose of this study was to estimate the hospital length of stay (LOS) and identify factors associated with LOS in orthognathic surgery patients.
Materials and Methods
Using a retrospective cohort study design, we enrolled a sample composed of patients who underwent orthognathic surgery at Massachusetts General Hospital between January 1994 and July 2006. The primary predictor variables were fixation type (rigid/nonrigid), anesthesia technique (hypotensive/normotensive), and perioperative steroid use (yes/no). The outcome variable was LOS. Descriptive statistics were computed for all variables. Bivariate analyses were used to identify factors associated with duration of LOS with P values less than .15. Multiple regression modeling was used to assess the relationship between the primary predictor variables and LOS. The level of statistical significance was set at P less than .05.
Results
The study sample was comprised of 627 subjects (58.5% female) with a mean age of 26.1 ± 10.2 years. The overall mean LOS was 1.7 ± 1.2 days. During the study period, LOS decreased from 2.3 to 1.3 days (P < .001). In the adjusted multiple regression model, rigid fixation, procedure type, and length of operation were statistically significantly associated with LOS (P < .05).
Conclusion
The results of this study indicate that individual variables associated with duration of LOS are complexity of the orthognathic procedure and type of fixation used. In the multiple logistic regression model, LOS decreases significantly when rigid fixation, hypotensive anesthesia, and perioperative steroids are used in combination.
⁎Former Predoctoral Student, Departments of Oral and Maxillofacial Surgery and Anesthesia, Massachusetts General Hospital Boston, MA.
†Former Resident in Oral and Maxillofacial Surgery, Departments of Oral and Maxillofacial Surgery and Anesthesia, Massachusetts General Hospital Boston, MA.
‡Former Resident in Oral and Maxillofacial Surgery, Departments of Oral and Maxillofacial Surgery and Anesthesia, Massachusetts General Hospital Boston, MA.
§Assistant in Anesthesia, Departments of Oral and Maxillofacial Surgery and Anesthesia, Massachusetts General Hospital Boston, MA.
∥Walter C. Guralnick Professor and Chairman, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA.
¶Associate Professor of Oral and Maxillofacial Surgery and Director, Center for Advanced Clinical Investigation, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA.
Address correspondence and reprint requests to Dr Dodson: Massachusetts General Hospital, Department of Oral and Maxillofacial Surgery, 55 Fruit Street, Warren Building, Suite 1201, Boston, MA 02114
Supported in part by the Oral and Maxillofacial Surgery Foundation Student Research Training Award and the Massachusetts General Hospital’s Department of Oral and Maxillofacial Surgery’s Center for Applied Clinical Investigation and Education and Research Fund.
ABSTRACT