A Nationwide Analysis of the Impact of Craniofacial Syndromes on Mandibular Distraction Osteogenesis Outcomes.

IF 1.1 4区 医学 Q2 Dentistry Cleft Palate-Craniofacial Journal Pub Date : 2025-03-02 DOI:10.1177/10556656251325125
Raina Kushal Patel, Eloise W Stanton, Melanie Bakovic, Valeria Mejia, Asli Pekcan, Cuauhtemoc Ayala-Chavez, Pasha Shakoori, Mark M Urata, Jeffrey A Hammoudeh
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引用次数: 0

Abstract

Objective: To investigate how craniofacial syndromes influence surgical outcomes of mandibular distraction osteogenesis (MDO), in order to optimize perioperative care.

Design: Retrospective cohort.

Setting: Single-center.

Patients/participants: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) database was queried for relevant Current Procedural Terminology (CPT) codes from 2012 to 2022. Patients with craniofacial syndromes were identified using ICD-9 and ICD-10 codes.

Intervention: Mandibular distraction osteogenesis.

Main outcome measures: 30-day perioperative adverse events including reoperation, readmission, and complications such as infection, dehiscence, pneumonia, sepsis, stroke, intracranial hemorrhage, nerve injury, and death.

Results: A total of 209 patients were identified, with 77 (36.8%) having a craniofacial syndrome. The average age at MDO was significantly younger for patients with craniofacial syndromes (99 days) versus the nonsyndromic group (389 days). Patients with craniofacial syndromes had a higher likelihood of undergoing reoperation within 30 days postoperatively (P = .003) and experienced a 1.5 times longer average length of stay (LOS) (P = .039). Additionally, these patients were less likely to achieve same-day discharge (P = .033). Although the overall complication rate was slightly higher in patients with craniofacial syndromes, these differences were not statistically significant.

Conclusions: This nationwide analysis indicates that while overall complication rates for MDO are similar, those with craniofacial syndromes face greater challenges, including higher reoperation rates, longer LOS, and lower same-day discharge rates, compared to patients without craniofacial syndromes. These results underscore the need for tailored postoperative care strategies to improve outcomes for this unique patient population.

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目的:研究颅面综合征如何影响下颌骨牵引成骨术(MDO)的手术效果:研究颅面综合征如何影响下颌骨牵引成骨术(MDO)的手术效果,以优化围手术期护理:设计:回顾性队列:单中心:在美国外科学院国家儿科手术质量改进计划(NSQIP-Pediatric)数据库中查询了2012年至2022年的相关现行手术术语(CPT)代码。使用ICD-9和ICD-10编码确定了颅颌面综合征患者:下颌骨牵引成骨术:30天围手术期不良事件,包括再次手术、再次入院以及感染、开裂、肺炎、败血症、中风、颅内出血、神经损伤和死亡等并发症:共发现209名患者,其中77人(36.8%)患有颅面综合征。颅面综合征患者的 MDO 平均年龄(99 天)明显小于非综合征组(389 天)。颅颌面综合征患者在术后 30 天内再次手术的可能性更高(P = .003),平均住院时间(LOS)延长了 1.5 倍(P = .039)。此外,这些患者当天出院的可能性较低(P = .033)。虽然颅面综合征患者的总体并发症发生率略高,但这些差异在统计学上并不显著:这项全国范围的分析表明,虽然MDO的总体并发症发生率相似,但与无颅面综合征的患者相比,有颅面综合征的患者面临着更大的挑战,包括更高的再手术率、更长的住院时间和更低的当日出院率。这些结果表明,有必要为这一特殊患者群体量身定制术后护理策略,以改善其治疗效果。
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来源期刊
Cleft Palate-Craniofacial Journal
Cleft Palate-Craniofacial Journal DENTISTRY, ORAL SURGERY & MEDICINE-SURGERY
CiteScore
2.20
自引率
36.40%
发文量
0
审稿时长
4-8 weeks
期刊介绍: The Cleft Palate-Craniofacial Journal (CPCJ) is the premiere peer-reviewed, interdisciplinary, international journal dedicated to current research on etiology, prevention, diagnosis, and treatment in all areas pertaining to craniofacial anomalies. CPCJ reports on basic science and clinical research aimed at better elucidating the pathogenesis, pathology, and optimal methods of treatment of cleft and craniofacial anomalies. The journal strives to foster communication and cooperation among professionals from all specialties.
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