Somatic and psychiatric aspects of complications outside the surgical area in orthognathic surgery: A retrospective study of 429 patients

TL;DR

This study examines non-surgical complications after orthognathic surgery and finds that psychiatric issues are common and linked to patient health history.

Contribution

The study identifies preoperative long-term diseases and substance abuse as predictors of postoperative non-surgical complications.

Findings

Severe psychiatric morbidity was the most common non-surgical complication.

Preoperative long-term disease and alcohol/substance abuse independently predicted complications.

Potentially life-threatening somatic complications occurred in 0.7% of patients.

Abstract

We explored postoperative non-surgical site complications in orthognathic surgery (OS) and investigated associations between outcome and patient- and surgery-related variables.

This single-centre (Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland) retrospective study included patients 18 years undergoing OS between January 2016 and December 2022. Data were manually reviewed from the hospital database. Associations with the outcome were analysed using SPSS software (IBM Corporation, 28.0.0.0).

Of 429 patients, 16 (3.7%) had a non-surgical site complication, and a total of 19 complications were recognized. A potentially life-threatening somatic complication occurred in 0.7% of patients. The most common complication was severe psychiatric morbidity, constituting 37% of all recognized complications. In the univariate and multivariable regression model, preoperative long-term disease (aOR 4.729; 95% CI 1.510-14.812; p=.008) and alcohol/substance abuse (p=.027) predicted the outcome independently. No other evaluated variables were associated with the outcome.

The results suggest that severe general complications are rare and are associated with patients' long-term diseases. Severe psychiatric complications comprised a significant proportion of all recognized complications. Attention should be paid to patients' somatic and psychiatric status at all stages of treatment.