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Risk Factors and Complication Rates of Inpatient Genioplasty Procedures in the U.S. Healthcare System: A 22-Year
Leonard Knoedler1,2, Robert Munzinger3, Benedikt Geldner4
1Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany. leonard.knoedler@charite.de.
Background:
Nationwide U.S. data describing inpatient genioplasty outcomes are limited, particularly regarding complication prevalence and predictors. Leveraging HCUP-NIS, this study characterized inpatient complication patterns by procedural approach, age, and socioeconomic markers.
Methods:
We conducted a retrospective HCUP‑NIS analysis (2000-2022) of inpatient genioplasty admissions, evaluating demographic, socioeconomic, procedural (osseous vs. non‑osseous), hospitalization (length of stay, charges, discharge), and inpatient‑coded complication variables, with subgroup comparisons by age, income quartile, and procedure type. Stratified univariate and multivariate logistic regression identified independent correlates of inpatient-coded complications.
Results:
The cohort included 485 inpatient genioplasty admissions (mean age 31.8 years; 53.4% female), predominantly privately insured and residing in higher income quartiles. Complications occurred in 10.3% (n = 50), and were higher in older vs. younger patients (14.8% vs. 5.8%; p = 0.002). Osseous genioplasty comprised 63.5% of admissions and showed longer hospitalization, higher charges and higher complication rates versus non-osseous procedures (12.7% vs. 6.2%; p = 0.04). Non‑elective admission, length of stay, and primary payer were independent predictors of complications in the osseous subgroup, whereas in the non‑osseous subgroup, length of stay was the only independent predictor (p < 0.0001).
Conclusion:
In a nationwide analysis of 485 inpatient genioplasty admissions, complications occurred in ~ 10% of patients, concentrated among older, more comorbid individuals. Prolonged length of stay was the most consistent correlate of complications across techniques, while non-elective admissions increased complication risk and resource use in the osseous subgroup. Lower-income patients experienced longer hospitalizations despite similar complication rates, highlighting persistent socioeconomic disparities. Future, larger-scale prospective trials are warranted to confirm our findings.
Level Of Evidence Iii:
Prognostic study. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
