Mandibular Fracture Severity and Patient Health Status Are Associated With Postoperative Inflammatory Complications
To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures. The investigators designed a case–control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004...
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| Published in | Journal of oral and maxillofacial surgery Vol. 69; no. 8; pp. 2191 - 2197 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York, NY
Elsevier Inc
01.08.2011
Elsevier |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0278-2391 1531-5053 1531-5053 |
| DOI | 10.1016/j.joms.2011.03.071 |
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| Abstract | To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures.
The investigators designed a case–control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004 and January 2010. Subjects who developed POICs after fracture management were categorized as cases. A POIC was defined as
1) recurrent swelling, fever, increased pain, or trismus;
2) wound dehiscence with purulent drainage;
3) exposed or infected hardware;
4) abscess formation;
5) radiographic evidence of osteomyelitis; and/or
6) presence of a fistula. Controls had no complications. For each case, 2 controls were selected. Predictor variables were categorized into the following sets: demographic, fracture-specific, and perioperative. Bivariate and multiple logistic regression analyses were used to identify factors associated with POICs.
During the study interval, 575 subjects with mandible fractures were evaluated and treated. The study sample consisted of 44 cases and 88 controls. In the multiple regression model, an increasing Mandibular Injury Severity Score (odds ratio = 1.4; 95% confidence interval 1.2-1.6) and a positive medical history (odds ratio = 1.4; 95% confidence interval 1.03-1.8) were significantly (
P < .05) associated with an increased risk for a POIC.
Fracture severity assessed using the Mandibular Injury Severity Score and pre-existing medical problems were associated with increased risk for postoperative inflammatory complications following treatment of mandibular fractures. |
|---|---|
| AbstractList | Purpose To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures. Patients and Methods The investigators designed a case–control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004 and January 2010. Subjects who developed POICs after fracture management were categorized as cases. A POIC was defined as 1 ) recurrent swelling, fever, increased pain, or trismus; 2 ) wound dehiscence with purulent drainage; 3 ) exposed or infected hardware; 4 ) abscess formation; 5 ) radiographic evidence of osteomyelitis; and/or 6 ) presence of a fistula. Controls had no complications. For each case, 2 controls were selected. Predictor variables were categorized into the following sets: demographic, fracture-specific, and perioperative. Bivariate and multiple logistic regression analyses were used to identify factors associated with POICs. Results During the study interval, 575 subjects with mandible fractures were evaluated and treated. The study sample consisted of 44 cases and 88 controls. In the multiple regression model, an increasing Mandibular Injury Severity Score (odds ratio = 1.4; 95% confidence interval 1.2-1.6) and a positive medical history (odds ratio = 1.4; 95% confidence interval 1.03-1.8) were significantly ( P < .05) associated with an increased risk for a POIC. Conclusion Fracture severity assessed using the Mandibular Injury Severity Score and pre-existing medical problems were associated with increased risk for postoperative inflammatory complications following treatment of mandibular fractures. To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures. The investigators designed a case–control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004 and January 2010. Subjects who developed POICs after fracture management were categorized as cases. A POIC was defined as 1) recurrent swelling, fever, increased pain, or trismus; 2) wound dehiscence with purulent drainage; 3) exposed or infected hardware; 4) abscess formation; 5) radiographic evidence of osteomyelitis; and/or 6) presence of a fistula. Controls had no complications. For each case, 2 controls were selected. Predictor variables were categorized into the following sets: demographic, fracture-specific, and perioperative. Bivariate and multiple logistic regression analyses were used to identify factors associated with POICs. During the study interval, 575 subjects with mandible fractures were evaluated and treated. The study sample consisted of 44 cases and 88 controls. In the multiple regression model, an increasing Mandibular Injury Severity Score (odds ratio = 1.4; 95% confidence interval 1.2-1.6) and a positive medical history (odds ratio = 1.4; 95% confidence interval 1.03-1.8) were significantly ( P < .05) associated with an increased risk for a POIC. Fracture severity assessed using the Mandibular Injury Severity Score and pre-existing medical problems were associated with increased risk for postoperative inflammatory complications following treatment of mandibular fractures. To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures.PURPOSETo identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures.The investigators designed a case-control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004 and January 2010. Subjects who developed POICs after fracture management were categorized as cases. A POIC was defined as 1) recurrent swelling, fever, increased pain, or trismus; 2) wound dehiscence with purulent drainage; 3) exposed or infected hardware; 4) abscess formation; 5) radiographic evidence of osteomyelitis; and/or 6) presence of a fistula. Controls had no complications. For each case, 2 controls were selected. Predictor variables were categorized into the following sets: demographic, fracture-specific, and perioperative. Bivariate and multiple logistic regression analyses were used to identify factors associated with POICs.PATIENTS AND METHODSThe investigators designed a case-control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004 and January 2010. Subjects who developed POICs after fracture management were categorized as cases. A POIC was defined as 1) recurrent swelling, fever, increased pain, or trismus; 2) wound dehiscence with purulent drainage; 3) exposed or infected hardware; 4) abscess formation; 5) radiographic evidence of osteomyelitis; and/or 6) presence of a fistula. Controls had no complications. For each case, 2 controls were selected. Predictor variables were categorized into the following sets: demographic, fracture-specific, and perioperative. Bivariate and multiple logistic regression analyses were used to identify factors associated with POICs.During the study interval, 575 subjects with mandible fractures were evaluated and treated. The study sample consisted of 44 cases and 88 controls. In the multiple regression model, an increasing Mandibular Injury Severity Score (odds ratio = 1.4; 95% confidence interval 1.2-1.6) and a positive medical history (odds ratio = 1.4; 95% confidence interval 1.03-1.8) were significantly (P < .05) associated with an increased risk for a POIC.RESULTSDuring the study interval, 575 subjects with mandible fractures were evaluated and treated. The study sample consisted of 44 cases and 88 controls. In the multiple regression model, an increasing Mandibular Injury Severity Score (odds ratio = 1.4; 95% confidence interval 1.2-1.6) and a positive medical history (odds ratio = 1.4; 95% confidence interval 1.03-1.8) were significantly (P < .05) associated with an increased risk for a POIC.Fracture severity assessed using the Mandibular Injury Severity Score and pre-existing medical problems were associated with increased risk for postoperative inflammatory complications following treatment of mandibular fractures.CONCLUSIONFracture severity assessed using the Mandibular Injury Severity Score and pre-existing medical problems were associated with increased risk for postoperative inflammatory complications following treatment of mandibular fractures. To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures. The investigators designed a case-control study and enrolled a sample of patients treated for mandibular fractures at Massachusetts General Hospital between August 2004 and January 2010. Subjects who developed POICs after fracture management were categorized as cases. A POIC was defined as 1) recurrent swelling, fever, increased pain, or trismus; 2) wound dehiscence with purulent drainage; 3) exposed or infected hardware; 4) abscess formation; 5) radiographic evidence of osteomyelitis; and/or 6) presence of a fistula. Controls had no complications. For each case, 2 controls were selected. Predictor variables were categorized into the following sets: demographic, fracture-specific, and perioperative. Bivariate and multiple logistic regression analyses were used to identify factors associated with POICs. During the study interval, 575 subjects with mandible fractures were evaluated and treated. The study sample consisted of 44 cases and 88 controls. In the multiple regression model, an increasing Mandibular Injury Severity Score (odds ratio = 1.4; 95% confidence interval 1.2-1.6) and a positive medical history (odds ratio = 1.4; 95% confidence interval 1.03-1.8) were significantly (P < .05) associated with an increased risk for a POIC. Fracture severity assessed using the Mandibular Injury Severity Score and pre-existing medical problems were associated with increased risk for postoperative inflammatory complications following treatment of mandibular fractures. |
| Author | Gordon, Paul E. Kaban, Leonard B. Dodson, Thomas B. Lawler, Matthew E. |
| Author_xml | – sequence: 1 givenname: Paul E. surname: Gordon fullname: Gordon, Paul E. organization: Resident-in-training, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine, Boston, MA – sequence: 2 givenname: Matthew E. surname: Lawler fullname: Lawler, Matthew E. organization: DMD Candidate, AO/Synthes Student Research Fellow in Pediatric Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine, Boston, MA – sequence: 3 givenname: Leonard B. surname: Kaban fullname: Kaban, Leonard B. organization: Chief and Walter C. Guralnick Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine, Boston, MA – sequence: 4 givenname: Thomas B. surname: Dodson fullname: Dodson, Thomas B. email: tbdodson@partners.org organization: Visiting Oral and Maxillofacial Surgeon; Director, Center for Applied Clinical Investigation; and Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine, Boston, MA |
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| Keywords | Human Postoperative Mandible Health status Treatment Stomatology Surgery Diseases of the osteoarticular system Complication Fracture Inflammation Trauma |
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| Snippet | To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures.
The investigators designed a... Purpose To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures. Patients and Methods... To identify risk factors associated with postoperative inflammatory complications (POICs) after treatment of mandibular fractures.PURPOSETo identify risk... |
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| SubjectTerms | Abscess - etiology Adult Biological and medical sciences Case-Control Studies Cutaneous Fistula - etiology Disease Edema - etiology Female Fever - etiology Fracture Fixation - methods Fractures, Comminuted - surgery Health Status Humans Immune System Diseases - complications Injuries of the limb. Injuries of the spine Injury Severity Score Male Mandibular Fractures - classification Mandibular Fractures - surgery Medical sciences Osteomyelitis - etiology Otorhinolaryngology. Stomatology Pain, Postoperative - etiology Postoperative Complications Risk Factors Substance-Related Disorders - complications Suppuration Surgery Surgical Wound Dehiscence - etiology Surgical Wound Infection - etiology Time Factors Traumas. Diseases due to physical agents Trismus - etiology Violence |
| Title | Mandibular Fracture Severity and Patient Health Status Are Associated With Postoperative Inflammatory Complications |
| URI | https://www.clinicalkey.com/#!/content/1-s2.0-S0278239111006100 https://www.clinicalkey.es/playcontent/1-s2.0-S0278239111006100 https://dx.doi.org/10.1016/j.joms.2011.03.071 https://www.ncbi.nlm.nih.gov/pubmed/21783003 https://www.proquest.com/docview/879106204 |
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