Inpatient Complications, Charges, and Length of Stay for Surgical Patients with Class III Malocclusions

Objectives: 1. To determine high risk factors for complications of inpatient orthognathic surgeries among patients with Class III malocclusions. 2. To provide an overview of hospital charges and length of stay for inpatient orthognathic surgeries among patients with Class III malocclusions. Methods: Any patient with Class III malocclusions but no craniofacial anomalies in the Nationwide Inpatient Sample (NIS) who underwent at least one of the orthognathic surgeries (based on International Classification of Disease-9-Clinical Modification procedure codes) between year 2006-2014 were included and examined for various complications. High occurrence complications were further studied by multivariable regression analysis to detect associations between different factors and the occurrence of complications. Results: Weighted total of 38,596 hospital stays were included in this study. The mean length of stay (LOS) for patients was 1.78 days while the median was 0.99 day. The mean total charges were $56,200 and the median of total hospital charges was $48,240. Maxillary hypoplasia alone (63%) was the most common reported diagnosis for in-hospital orthognathic surgeries in the U.S. for Class III malocclusions during 2006-2014. The overall complication rate among these patients was 2.28%. The two most frequent complications were hemorrhage (0.96%) and iatrogenic complications (0.75%). While having comorbid conditions increased the occurrence of both hemorrhage and iatrogenic complications, being female had a protective effect against both hemorrhage and iatrogenic complications. Conclusions: Some patient-related factors had significant association with the occurrence of complications. Years of admission were also shown to be related to the occurrence of complications. Hospital-related factors did not show significant association with the occurrence of complications.