Changing patterns of hospital length of stay after orthognathic surgery.
OBJECTIVE
The purpose of this study was to estimate the hospital length of stay (LOS) and identify factors associated with LOS in orthognathic surgery patients.


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).


CONCLUSIONS
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.
Huamán
Evelyn T
ET
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital Boston, MA 02114, USA.
Juvet
Lawrence M
LM
Nastri
Alf
A
Denman
William T
WT
Kaban
Leonard B
LB
Dodson
Thomas B
TB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D016268:Internal Fixators / Q000706:statistics & numerical data; D019248:Jaw Fixation Techniques / Q000295:instrumentation / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D008875:Middle Aged; D009971:Orthodontics, Corrective / Q000706:statistics & numerical data; D056948:Orthognathic Surgical Procedures; D010027:Osteotomy / Q000379:methods / Q000706:statistics & numerical data; D019340:Osteotomy, Le Fort / Q000379:methods / Q000706:statistics & numerical data; D013256:Steroids / Q000627:therapeutic use; D013997:Time Factors
D013256:Steroids