Facial fracture repair and diabetes mellitus: An examination of postoperative complications
| Autor: | Soly Baredes, Adam J. Folbe, Jean Anderson Eloy, Mahdi A. Shkoukani, Milap D. Raikundalia, Peter F. Svider, Curtis Hanba |
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| Rok vydání: | 2016 |
| Předmět: |
Diplopia
Surgical repair medicine.medical_specialty Enophthalmos business.industry Disease medicine.disease Logistic regression Surgery 03 medical and health sciences 0302 clinical medicine Otorhinolaryngology Diabetes mellitus medicine medicine.symptom Antibiotic prophylaxis 030223 otorhinolaryngology business Complication 030217 neurology & neurosurgery |
| Zdroj: | The Laryngoscope. 127:809-814 |
| ISSN: | 0023-852X |
| Popis: | Objectives/Hypothesis Our objectives included using a nationally representative resource to evaluate charges, demographics, and complication rates among diabetics undergoing surgical repair of facial fractures. Methods We evaluated the Nationwide Inpatient Sample, a database encompassing nearly 8 million hospitalizations, for patients with a diagnosis of a facial fracture who underwent surgical intervention during their hospitalization. Patients were organized by whether they had a diagnosis of diabetes mellitus (DM). Results Of 45,509 inpatients included, diabetics had greater costs, longer length of stays, and were significantly more likely to have a host of baseline comorbidities. On multivariate logistic regression corrected for age, race, gender, and preexisting cardiac disease, DM patients had significantly greater odds for cardiac complications (3.3; P < 0.001) and hepatic failure (15.0; P = 0.007). There were no significant differences associated with DM in the rates of enophthalmos, epiphora, and diplopia among patients with orbital fractures. Diabetics did have a significantly greater risk of postoperative infection after mandible repair. Conclusion In addition to a significant association with greater length of stay and increased hospital charges, DM patients undergoing surgical repair of facial fractures had a significantly greater risk of postoperative complications, including cardiac complications. Diabetics undergoing mandible repair had a greater risk of postoperative infection, even upon controlling for demographic factors, suggesting the need for further study evaluating the role of postoperative antibiotic prophylaxis in this patient population. These findings reveal the potential value of developing and using standardized postoperative care algorithms aimed at minimizing complications in this susceptible population. Level of Evidence 2c. Laryngoscope, 127:809–814, 2017 |
| Databáze: | OpenAIRE |
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