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美国正颌外科手术的出院模式。

Discharge patterns of orthognathic surgeries in the United States.

作者信息

Venugoplan Shankar R, Nanda Vikrum, Turkistani Khadijah, Desai Shamik, Allareddy Veerasathpurush

机构信息

Harvard School of Dental Medicine, Boston, MA 02115, USA.

出版信息

J Oral Maxillofac Surg. 2012 Jan;70(1):e77-86. doi: 10.1016/j.joms.2011.09.030.

Abstract

PURPOSE

The aim of the present study was to provide a nationally representative estimate of the number and type of different orthognathic procedures performed in hospitalized patients in the United States.

METHODS

The Nationwide Inpatient Sample for 2008 was used. All hospitalizations for orthognathic surgeries were included. Procedures were identified using the procedure codes of the International Classification of Diseases, Ninth Revision, Clinical Modification. Outcomes, including complications, hospitalization, charges, and length of stay, were examined. All estimates were projected to national levels, taking into consideration the complex sampling frame of the dataset and the discharge weight variable.

RESULTS

There were 10,345 hospitalizations for orthognathic surgery. The average age of the hospitalized patients was 26.7 years. Whites, blacks, Hispanics, Asian/Pacific Islanders, Native Americans, and other races constituted 71.9%, 4.9%, 12.6%, 5.6%, 0.4%, and 4.6% of the hospitalizations, respectively. Private insurance plans were the primary payers for 77.3% of all procedures. Segmental osteoplasty of the maxilla was the procedure performed most often (45.8% of all hospitalizations), followed by open osteoplasty of the mandibular ramus (31.7%). Complications included iatrogenic-induced complications (1.5% of all hospitalizations), hemorrhagic complications (1.2%), and bacterial infections (0.6%). The mean charge per hospitalization was $47,348. The total hospitalization charge for the entire United States was close to $466.8 million. The mean length of stay was 2.95 days and the total duration of hospitalization in the entire United States was 30,580 days.

CONCLUSIONS

This study provides nationwide estimates of hospital discharge patterns and outcomes in patients undergoing orthognathic surgeries in United States hospitals. Future studies should examine factors associated with outcomes.

摘要

目的

本研究的目的是对美国住院患者接受的不同正颌手术的数量和类型提供全国代表性估计。

方法

使用2008年全国住院患者样本。纳入所有正颌手术住院病例。使用《国际疾病分类,第九版,临床修订本》的手术编码识别手术。检查包括并发症、住院情况、费用和住院时间在内的结果。考虑到数据集复杂的抽样框架和出院权重变量,所有估计值均推算至全国水平。

结果

有10345例正颌手术住院病例。住院患者的平均年龄为26.7岁。白人、黑人、西班牙裔、亚太岛民、美国原住民和其他种族分别占住院病例的71.9%、4.9%、12.6%、5.6%、0.4%和4.6%。私人保险计划是所有手术77.3%的主要支付方。上颌骨节段性截骨术是最常进行的手术(占所有住院病例的45.8%),其次是下颌升支开放性截骨术(31.7%)。并发症包括医源性并发症(占所有住院病例的1.5%)、出血性并发症(1.2%)和细菌感染(0.6%)。每次住院的平均费用为47348美元。美国全国的住院总费用接近4.668亿美元。平均住院时间为2.95天,美国全国的住院总时长为30580天。

结论

本研究提供了美国医院接受正颌手术患者的全国出院模式和结果估计。未来研究应检查与结果相关的因素。

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