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Fractures: Bone Repair01:27

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Flail Chest-I01:24

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Overview of Flail Chest
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Updated: Oct 9, 2025

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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ASA Physical Status Classification and Complications Following Facial Fracture Repair.

Parisorn Thepmankorn1, Chris B Choi1, Sean Z Haimowitz1

  • 1Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

The Annals of Otology, Rhinology, and Laryngology
|December 17, 2021
PubMed
Summary
This summary is machine-generated.

Patients with higher American Society of Anesthesiologists (ASA) physical status classification face increased risks for complications after facial fracture repair. This includes longer hospital stays and higher rates of infection and bleeding.

Keywords:
ASA classfacial fracturefacial plasticshead and neck surgeryhealth status risk assessmentmaxillofacial injuriespostoperative complications

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Area of Science:

  • Anesthesiology
  • Oral and Maxillofacial Surgery
  • Trauma Surgery

Background:

  • Facial fracture repair involves complex surgical procedures.
  • Patient comorbidities can significantly impact surgical outcomes.
  • The American Society of Anesthesiologists (ASA) physical status classification is a widely used metric for assessing patient health.

Purpose of the Study:

  • To determine the association between ASA physical status classification and postoperative complication rates in patients undergoing facial fracture repair.
  • To identify specific complications linked to higher ASA classes in this patient population.

Main Methods:

  • Retrospective cohort study of 3575 patients undergoing facial fracture repair.
  • Patients categorized into ASA Class I/II and Class III/IV cohorts.
  • Statistical analyses included chi-square, Fisher's exact tests, and multivariate logistic regression.

Main Results:

  • Patients in ASA Class III/IV exhibited significantly higher rates of deep surgical site infection, bleeding, readmission, reoperation, and overall postoperative complications compared to Class I/II.
  • Multivariate analysis confirmed ASA Class III/IV was independently associated with increased length of stay and overall complication risk.
  • Specifically, higher ASA class correlated with increased deep surgical site infection, postoperative bleeding, and failure to wean off ventilator.

Conclusions:

  • Higher ASA physical status is a significant predictor of adverse postoperative outcomes following facial fracture repair.
  • These outcomes include extended hospital stays and increased risks for surgical site infections, bleeding, and respiratory complications.
  • Awareness of these risks is crucial for surgeons managing patients with higher ASA classifications undergoing facial fracture repair.