Aftab Owais M, Randhawa Avneet, Randhawa Karandeep S, Khawaja Imran M, Kumar Keshav, Langer Paul D, Eloy Jean Anderson, Fang Christina H
Department of Otolaryngology- Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ USA.
Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ USA.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3323-3329. doi: 10.1007/s12070-024-04681-0. Epub 2024 Apr 20.
To analyze the association between emergent surgery status and systemic adverse outcomes in patients undergoing open orbital floor blowout fracture repair.
This retrospective cohort analysis utilized the 2005-2018 National Surgery Quality Improvement Program (NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify cases with open treatment of orbital floor blowout fractures (21385, 21386, 21387, 21390, 21395). Demographics, comorbidities, and complication incidences were compared between patients undergoing emergent surgery and those undergoing non-emergent orbital blowout fracture repair using chi-square analyses. The independent effect of preoperative emergent status on adverse outcomes was analyzed using binary logistic regression.
1,146 (96.0%) non-emergent and 48 (4.0%) emergent orbital blowout fracture repairs were identified from 2005 to 2018. Chi-square analysis indicated patients undergoing emergent repairs had higher incidences of preoperative wound infection (8.3% vs. 2.3%; = 0.029) and systemic sepsis (8.3% vs. 0.6%; = 0.001). The emergent cohort had a higher proportion of patients with Hispanic ethnicity ( = 0.011). Unadjusted chi-square analysis indicated the emergent cohort had a higher incidence of prolonged length of stay (50.1% vs. 10.1%; < 0.001). After adjusting for confounders, logistic regression analysis indicated emergent status was an independent risk factor for prolonged length of stay (OR 13.05; 95% CI 5.26-32.37; < 0.001).
Emergent surgery status is an important factor associated with increased odds of prolonged length of stay in patients undergoing open orbital blowout fracture repair.
The online version contains supplementary material available at 10.1007/s12070-024-04681-0.
分析开放性眶底爆裂骨折修复患者的急诊手术状态与全身不良结局之间的关联。
这项回顾性队列分析使用了2005 - 2018年国家外科质量改进计划（NSQIP）数据库。采用当前手术操作术语（CPT）编码来识别开放性眶底爆裂骨折治疗病例（21385、21386、21387、21390、21395）。使用卡方分析比较急诊手术患者与非急诊眶爆裂骨折修复患者的人口统计学、合并症和并发症发生率。采用二元逻辑回归分析术前急诊状态对不良结局的独立影响。
2005年至2018年共识别出1146例（96.0%）非急诊和48例（4.0%）急诊眶爆裂骨折修复病例。卡方分析表明，急诊修复患者术前伤口感染发生率（8.3%对2.3%；P = 0.029）和全身脓毒症发生率（8.3%对0.6%；P = 0.001）更高。急诊队列中西班牙裔患者比例更高（P = 0.011）。未调整的卡方分析表明，急诊队列住院时间延长的发生率更高（50.1%对10.1%；P < 0.001）。在对混杂因素进行调整后，逻辑回归分析表明急诊状态是住院时间延长（OR 13.05；95% CI 5.26 - 32.37；P < 0.001）的独立危险因素。
急诊手术状态是开放性眶爆裂骨折修复患者住院时间延长几率增加的一个重要相关因素。
在线版本包含可在10.1007/s12070 - 024 - 04681 - 0获取的补充材料。
