Risk Factors Associated With Complications After Treatment of Mandible Fractures
Tsung-Yen Hsieh1, Jamie L Funamura1, Raj Dedhia1
1Department of Otolaryngology-Head & Neck Surgery, University of California, Davis, Sacramento.
JAMA Facial Plastic Surgery
|January 25, 2019
Summary
Timely treatment of mandible fractures is crucial. Delays, tobacco use, dental extraction, and distance from care increase complication risks, highlighting the need for prompt intervention to improve patient outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
- Public Health
Background:
- Mandible fractures can lead to significant patient morbidity.
- Identifying modifiable risk factors is essential for improving treatment outcomes.
- Previous studies have not fully elucidated the multifactorial risks associated with mandible fracture complications.
Purpose of the Study:
- To identify risk factors associated with complications in patients treated for mandible fractures.
- To provide data that can guide clinical practice and improve patient outcomes.
- To analyze the impact of treatment timing, patient behaviors, and geographic factors on complication rates.
Main Methods:
- Retrospective review of 137 patients with mandible fractures treated at a Level 1 trauma center.
- Analysis of demographic characteristics and outcomes with a minimum 3-week follow-up.
- Multivariate logistic regression to identify factors associated with postoperative complications.
Main Results:
- Complications occurred in 21.2% of patients, including surgical site infections, nonunion, and hardware exposure.
- Increased time from injury to treatment (OR 1.60), tobacco use (OR 8.10), and dental extraction (OR 93.00) were significantly associated with complications.
- Living farther from the treatment facility was linked to fewer complications (OR 0.08).
Conclusions:
- Complications following mandible fracture treatment are associated with delayed intervention, tobacco use, and dental extractions.
- System-level interventions to expedite treatment for mandible fractures may reduce complication rates.
- Addressing modifiable risk factors like tobacco use and optimizing treatment timelines are key to improving patient outcomes.
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