Qiao Feng, Li Lei, Zhang Jing, Dong Rui, Sun Jun
Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tianjin Medical University, Tianjin, China.
Department of Stomatology, Aerospace Center Hospital, Beijing, China.
Ann Palliat Med. 2021 Apr;10(4):4080-4089. doi: 10.21037/apm-20-2340. Epub 2021 Mar 12.
To investigate the association between operation time and serious postoperative symptom severity (PoSS) in patients following the surgical removal of mandibular third molar (M3M), independent of the degree of impaction.
A retrospective hospital-based observational study was carried out at the Stomatology Hospital of Tianjin Medical University. The operation time was recorded and divided by quartiles (Q1-Q4). The primary outcome was PoSS. Clinical, demographic and radiologic variables were also recorded. A descriptive bivariate analysis was performed. Associations were analyzed using the adjusted multivariate logistic regression. The association between time and impaction status was also tested. Potential nonlinear associations were evaluated with the restricted cubic spline. P values of <0.05 were considered as statistically significant.
A total of 321 patients met our inclusion criteria (114 men and 207 women). The mean operation time was 16.0 minutes (range, 1.1 to 40.5 minutes). The odds ratio (OR) and 95% confidence interval (CI) were determined after multivariate adjustments for the risk of serious PoSS per 5-min incremental increase in operation time (OR 1.201, 95% CI, 1.005-1.434). The multivariable-adjusted ORs (95% CI) of PoSS across the categories of operation time were as follows: 1.00 (reference), 1.765 (0.770-4.045), 2.567 (1.047-6.293), and 3.085 (1.180-8.064) (P for trend =0.027). The test of interaction effect was not significant (all P for interaction >0.05). No evidence of a nonlinear association was observed (P for nonlinearity =0.117).
Operation time was significantly and positively associated with a high risk of serious PoSS independent of impaction status in patients who underwent the surgical removal of M3M.
研究下颌第三磨牙（M3M）拔除术后患者的手术时间与术后严重症状严重程度（PoSS）之间的关联，且不考虑阻生程度。
在天津医科大学口腔医院进行了一项基于医院的回顾性观察研究。记录手术时间并按四分位数（Q1-Q4）进行划分。主要结局为PoSS。还记录了临床、人口统计学和放射学变量。进行了描述性双变量分析。使用调整后的多变量逻辑回归分析关联。还测试了时间与阻生状态之间的关联。用受限立方样条评估潜在的非线性关联。P值<0.05被认为具有统计学意义。
共有321例患者符合纳入标准（114例男性和207例女性）。平均手术时间为16.0分钟（范围为1.1至40.5分钟）。在对手术时间每增加5分钟严重PoSS风险进行多变量调整后，确定了优势比（OR）和95%置信区间（CI）（OR 1.201，95% CI，1.005-1.434）。PoSS在不同手术时间类别中的多变量调整OR（95% CI）如下：1.00（参考值），1.765（0.770-4.045），2.567（1.047-6.293）和3.085（1.180-8.064）（趋势P值=0.027）。交互作用效应检验无显著性（所有交互作用P值>0.05）。未观察到非线性关联的证据（非线性P值=0.117）。
在接受M3M拔除术的患者中，手术时间与严重PoSS的高风险显著正相关，且与阻生状态无关。
