title: Impact of intraoperative fluid administration on length of postoperative hospital stay following orthognathic surgery.
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether the volume of intraoperative fluids administered to patients during routine orthognathic surgery is associated with increased length of hospital stay for postoperative convalescence.
  
  
  METHODS
  A retrospective cohort study design was used to identify 168 patients undergoing routine orthognathic surgery at Mayo Clinic from 2010 through 2014. The primary predictor variable was total volume of intravenous fluids administered during orthognathic surgery. The primary outcome variable was the length of hospital stay in hours as measured from the completion of the procedure to patient dismissal from the hospital. Additional covariates were collected including patient demographic data, preoperative American Society of Anesthesiologists (ASA) score, type of intravenous fluid administered, complexity of surgical procedure, and duration of anesthesia.
  
  
  RESULTS
  On univariate analysis, total fluid was significantly associated with increased length of stay (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.42 to 2.33; P < .001). After adjustment for surgical complexity and duration of anesthesia on multivariable regression analysis, the association of fluid level with length of hospital stay was no longer statistically significant (OR, 0.86; 95% CI, 0.61 to 1.22; P = .39). Duration of anesthesia remained the only covariate that was significantly associated with increased length of hospital stay in the multivariable regression model (OR, 2.21; 95% CI, 1.56 to 3.13; P < .001).
  
  
  CONCLUSIONS
  Among surgical complexity, duration of anesthesia, and total volume of intraoperative intravenous fluids administered for routine orthognathic surgery, the duration of anesthesia has the strongest predictive value for patients requiring prolonged hospital stay for postoperative convalescence.
authors.affiliation: Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN. Electronic address: ettinger.kyle@mayo.edu.
authors.forename: Kyle S
authors.initials: KS
authors.lastname: Ettinger
authors.affiliation: Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Yildirim
authors.affiliation: Assistant Professor of Surgery and Consultant, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.
authors.forename: James M
authors.initials: JM
authors.lastname: Van Ess
authors.affiliation: Former Assistant Professor of Surgery and Consultant, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Rieck
authors.affiliation: Assistant Professor of Surgery and Program Chair, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Viozzi
authors.affiliation: Assistant Professor of Surgery and Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.
authors.forename: Kevin
authors.initials: K
authors.lastname: Arce
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000706:statistics & numerical data; D015331:Cohort Studies; D003102:Colloids; D003289:Convalescence; D000077324:Crystalloid Solutions; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D005544:Forecasting; D063172:Genioplasty / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007430:Intraoperative Care / Q000706:statistics & numerical data*; D007552:Isotonic Solutions / Q000008:administration & dosage; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D056948:Orthognathic Surgical Procedures / Q000706:statistics & numerical data*; D019340:Osteotomy, Le Fort / Q000706:statistics & numerical data; D059229:Osteotomy, Sagittal Split Ramus / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D015532:Rehydration Solutions / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D015532:Rehydration Solutions