title: Prevalence and predictors of complications following facial reconstruction procedures.
abstract: Facial reconstruction procedures are immensely challenging and are done for a multitude of reasons. The purpose of this report is to provide nationally representative estimates of different types of facial reconstructive procedures and to examine prevalence and predictors of a wide range of complications associated with these procedures in the USA. The Nationwide Inpatient Sample, the largest inpatient dataset for the USA, was used. Data for the years 2004-2010 related to facial reconstruction procedures were identified through ICD-9-CM procedure codes. Associated complications were identified using secondary diagnosis field codes. Multivariable logistic regression models were used to examine the association between patient/hospital-level factors and the occurrence of complications. A total 26,374 facial reconstruction procedures were performed. About 20% of all patients who had facial reconstruction procedures developed a complication. Frequently occurring complications included postoperative pneumonia (4.9% of hospitalizations), hemorrhage (3.9%), other infections (3.6%), non-healing wounds (3.5%), and iatrogenically induced complications (3.2%). Significant factors found to be consistently associated with different types of complications included age, co-morbid burden, sex, and type of admission. The reported results are generalizable within limitations and can be used by health care providers to tailor quality improvement initiatives to minimize or better treat complications in the high-risk cohorts.
authors.affiliation: Department of Periodontology, Oregon Health and Sciences University, Portland, OR, USA.
authors.forename: S
authors.initials: S
authors.lastname: Prakasam
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Stein
authors.affiliation: Children's Hospital of Los Angeles, Los Angeles, CA, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Lee
authors.affiliation: University of Nebraska Medical Center, College of Public Health, Omaha, NE, USA.
authors.forename: S
authors.initials: S
authors.lastname: Rampa
authors.affiliation: College of Dentistry, The University of Michigan, Ann Arbor, MI, USA.
authors.forename: R
authors.initials: R
authors.lastname: Nalliah
authors.affiliation: Department of Pediatric Critical Care, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: V
authors.initials: V
authors.lastname: Allareddy
authors.affiliation: Department of Orthodontics, College of Dentistry, The University of Iowa, Iowa City, IA, USA. Electronic address: Veerasathpurush-Allareddy@uiowa.edu.
authors.forename: V
authors.initials: V
authors.lastname: Allareddy
mesh_terms: D015897:Comorbidity; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D005145:Face / Q000601:surgery*; D005260:Female; D006760:Hospitalization; D006801:Humans; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies
keywords: complications; facial reconstruction; hospitalizations