Artículos de revistas
Morbidity And Mortality Rates After Maxillomandibular Advancement For Treatment Of Obstructive Sleep Apnea
Registro en:
Journal Of Oral And Maxillofacial Surgery . W B Saunders Co-elsevier Inc, v. 74, p. 2033 - 2043, 2016.
0278-2391
1531-5053
WOS:000389511800020
10.1016/j.joms.2016.04.005
Autor
Passeri
Luis A.; Choi
James G.; Kaban
Leonard B.; Lahey
Edward T.
Institución
Resumen
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) To compare morbidity and mortality rates in obstructive sleep apnea (OSA) versus dentofacial deformity (DFD) patients undergoing equivalent maxillofacial surgical procedures. Patients and Methods: Patients with OSA who underwent maxillomandibular advancement with genial tubercle advancement in the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery from December 2002 to June 2011 were matched to patients with DFD undergoing similar maxillofacial procedures during the same period. They were compared regarding demographic variables, medical comorbidities, perioperative management, intraoperative complications, early and late postoperative complications, and mortality rate. Results: A study group of 28 patients with OSA and a control group of 26 patients with DFD were compared. The patients with OSA were older (41.9 +/- 12.5 years vs 21.7 +/- 8.6 years), had a higher American Society of Anesthesiologists classification (2.0 +/- 0.5 vs 1.3 +/- 0.6), and had a higher body mass index (29.6 +/- 4.7 kg/m(2) vs 23.0 +/- 3.1 kg/m(2)). They also had a greater number of medical comorbidities (2.4 +/- 2.3 vs 0.7 +/- 1.0). More OSA patients than DFD patients had complications (28 [100%] vs 19 [73%], P = .003), and the total number of complications in the OSA group was higher (108 vs 33, P < .001). Of the complications, 13.9% in the OSA group and 3.0% in the DFD group were classified as major. The absolute risk of a complication was 3.9 for the OSA group versus 1.3 for the DFD group. The relative risk of complications in OSA patients compared with DFD patients was 3.0. No difference in mortality rate was found. Conclusions: The patients in the OSA group were older, had more comorbidities, and ultimately had a greater number of early, late, minor, and major complications than those in the DFD group. The incidence of death in both groups was zero. Maxillomandibular advancement appears to be a safe procedure regarding mortality rate, but OSA patients should be counseled preoperatively regarding the relative increased risk of complications. (C) 2016 American Association of Oral and Maxillofacial Surgeons 74 10 2033 2043 Harvard Catalyst-The Harvard Clinical and Translational Science Center (National Center for Research Resources) Harvard University Massachusetts General Hospital Department of Oral and Maxillofacial Surgery Education and Research Fund Brazilian National Council for Scientific and Technological Development (CNPq) Coordination for the Improvement of Higher Education Personnel (CAPES) Harvard Catalyst-The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health) [UL1TR001102] Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)