title: Orthognathic Surgery Patients (Maxillary Impaction and Setback plus Mandibular Advancement plus Genioplasty) Need More Intensive Care Unit (ICU) Admission after Surgery.
abstract: BACKGROUND
  Due to shortage of ICU beds in hospitals, knowing what kind of orthognathic surgery patients more need ICU care after surgery would be important for surgeons and hospitals to prevent unnecessary ICU bed reservation.
  
  
  OBJECTIVE
  The aim of the present study was to determine what kinds of orthognathic surgery patients would benefit more from ICU care after surgery.
  
  
  METHODS
  210 patients who were admitted to Chamran Hospital, Shiraz, for bimaxillary orthognathic surgery (2008-2013) were reviewed based on whether they had been admitted to ICU or maxillofacial surgery ward. Operation time, sex, intraoperative Estimated Blood Loss (EBL), postoperative complications, ICU admission, and unwanted complications resulting from staying in ICU were assessed.
  
  
  RESULTS
  Of 210 patients undergoing bimaxillary orthognathic surgery, 59 patients (28.1%) were postoperatively admitted to the ICU and 151 in the maxillofacial ward (71.9%). There was not statistically significant difference in age and sex between the two groups (p> 0.05). The groups were significantly different in terms of operation time (p< 0.001). Blood loss For ICU admitted patients was 600.00±293.621mL and for those who were hospitalized in the ward was 350.00±298.397 mL. Statistically significant differences were found between the two groups (p< 0.001). Moreover, there was a direct linear correlation between operation time and intraoperative estimated blood loss and this relationship was statistically significant (r=0.42, p< 0.001). Patients with maxillary impaction and setback plus mandibular advancement plus genioplasty were among the most ICU admitted patients (44%), while these patients were only 20% of all patients who were admitted to the ward. As a final point, the result illustrated that patients who were admitted to the ICU experienced more complication such as bleeding, postoperative nausea, and pain (p< 0.001).
  
  
  CONCLUSIONS
  Orthognathic surgery patients (maxillary impaction and setback plus mandibular advancement plus genioplasty) due to more intraoperative bleeding and postoperative nausea and pain would benefit from ICU admission after surgery.
authors.affiliation: Dept. of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Eftekharian
authors.affiliation: Dept. of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Barbad
authors.initials: B
authors.lastname: Zamiri
authors.affiliation: Undergraduate Student, Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Shamseddin
authors.initials: S
authors.lastname: Ahzan
authors.affiliation: Undergraduate Student, Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Mohamad
authors.initials: M
authors.lastname: Talebi
authors.affiliation: Postgraduate, Dept. of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Kamal
authors.initials: K
authors.lastname: Zarei
keywords: Bimaxillary Orthognathic Surgery; Estimated Blood Loss; Intensive Care Unit (ICU); Maxillary Impaction