Epidemiological Estimates Of Outcomes In Patients Undergoing Orthognathic Surgeries

Objectives: The objective of the current study is to provide nationally representative estimates of the number and type of different orthognathic procedures performed in the United States during the years 2000 through 2008.

Methods: The Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project for the years 2000 to 2008 was used. All hospitalizations that underwent orthognathic surgeries were included. Outcomes including hospitalization charges, complications, and length of stay were examined. The complex sampling frame was taken into consideration while conducting the data analysis. The hospital strata were used as the stratification unit and each individual hospitalization was the unit of analysis.

Results: A total of 108,264 hospitalizations underwent an orthognathic surgery during the study period. The average age of the hospitalizations was 28 years. Females comprised 58.5% of all hospitalizations. Segmental osteoplasty of the maxilla was the most often performed procedure (43% of all hospitalizations) followed by open osteoplasty of the mandibular ramus (29%). Complications included hemorrhagic complications (1.1% of all hospitalizations), iatrogenic induced complications (1.05%),bacterial infections (0.4%), respiratory complications (0.4%), cardiac complications (0.3%), post-operative pneumothorax (0.2%), decubitus ulcers (0.2%), septicemia (0.2%), and mycoses (0.2%). The mean charge per hospitalization ranged from $19,305 in the year 2000 to $47,348 in 2008. The mean length of stay was 2.6 days. Sixty patients died in hospitals. Close to 65% of all procedures were performed in teaching hospitals. Private insurance plans covered 77.7% of all hospitalizations while Medicare, Medicaid, and Other insurance plans were the payers for 2.5%, 8.9%, and 3.8% of hospitalizations respectively. 7% of all hospitalizations were uninsured.

Conclusions: This report provides comprehensive national estimates for orthognathic surgical procedures performed throughout the United States during the years 2000 to 2008. There is a significant knowledge gap to improve access and quality of care for patients seeking orthognathic surgical procedures.