Outpatient treatment just as safe for jaw fractures, study finds

Sep 30, 2010

(PhysOrg.com) -- New research by UC oral and maxillofacial surgeons suggests that treating isolated lower jaw fractures on an outpatient basis has the same outcome and significantly lowers health care costs.

Michael Grau, DMD, is presenting his abstract, titled "Safety and cost-efficiency in treating mandibular fractures non-emergently” at the 2010 meeting of the American Association of Oral and Maxillofacial Surgeons (AAOMS), Sept. 27-Oct. 2 in Chicago.

To conduct his research, Grau examined 440 cases of lower jaw fractures, all treated by the UC division of oral and maxillofacial surgery between July 2004 and June 2009.

He divided patients into groups based on how soon they received care after their injury (0 to 72 hours, three to seven days and seven days plus) and then evaluated the cases for the presence of complications requiring a return trip to the operating room.

"A complication could be anything from an infection that requires surgical draining to a removal of infected hardware or a fracture that didn’t heal properly,” says Grau. Anything that could be treated with a minor outpatient visit to the doctor was not counted as a complication.

"The main thing we were looking at was the complication rate in relation to how quickly they were treated after their initial injury, looking for any differences between patients treated immediately and those treated days after,” he says.

What they found was little to no difference in complication rate among groups—meaning that jaw fracture patients can be treated on a non-emergency or outpatient basis without increasing the risk of further complications.

It’s an important finding for both patients and hospitals.

Admitting patients into the hospital immediately after injury does not always guarantee faster treatment, says Deepak Krishnan, DDS, assistant professor of surgery and residency program director.

"Depending on the time of their injury and admittance, sometimes patients can wait several hours, sometimes days to get into surgery,” he says. "That causes a great deal of stress for the patient. You can’t eat or drink anything before surgery—and often the surgery will be delayed if surgeons are called to more urgent cases.”

Sending the patients home with adequate pain coverage and antibiotics allows them to avoid the stress of a hospital stay and return to receive scheduled treatment at a location convenient to them.

It also reduces costs for health care providers.

"There’s no nursing cost for an overnight hospital stay, there’s no cost for treatment of hospital stay-associated complications. … The cost was dramatically improved with no difference in outcome,” says Krishnan. "We’re trying to be careful with how we spend our medical dollars and we’re concerned about care for people.”

Krishnan further notes that the cases studied were at UC Health University Hospital, a Level I trauma center: "So we are seeing the worst of the worst cases, the ones that could potentially have all of the possible complications. We’ve shown in five years of experience that outpatient care is a very acceptable way of treating them, without any adverse effects on the outcomes.”

Oral and maxillofacial surgery researchers will also present three other abstracts at the AAOMS conference, including work on trends in antibiotic usage about facial trauma providers, cleft lip/palate surgery and treatment of cysts in the orofacial region.

Explore further: Humiliation tops list of mistreatment toward med students

add to favorites email to friend print save as pdf

Related Stories

Diabetics experience more complications following trauma

Jul 16, 2007

Individuals with diabetes appear to spend more days in the intensive care unit, use more ventilator support and have more complications during hospitalization for trauma than non-diabetics, according to a report in the July ...

Awake sedation for brain surgery may shorten hospital stay

Jun 18, 2010

The recovery time and cost of brain-tumor surgery might both be reduced if surgery is performed while patients are awake during part of the procedure, according to a new study conducted at The Ohio State University Comprehensive ...

Recommended for you

Humiliation tops list of mistreatment toward med students

7 hours ago

Each year thousands of students enroll in medical schools across the country. But just how many feel they've been disrespected, publicly humiliated, ridiculed or even harassed by their superiors at some point during their ...

Surrogate offers clues into man with 16 babies

15 hours ago

When the young Thai woman saw an online ad seeking surrogate mothers, it seemed like a life-altering deal: $10,000 to help a foreign couple that wanted a child but couldn't conceive.

Nurses go on strike in Ebola-hit Liberia

15 hours ago

Nurses at Liberia's largest hospital went on strike on Monday, demanding better pay and equipment to protect them against a deadly Ebola epidemic which has killed hundreds in the west African nation.

ALS Ice Bucket Challenge arrives in North Korea

Aug 31, 2014

It's pretty hard to find a novel way to do the ALS Ice Bucket Challenge by now, but two-time Grammy-winning rapper Pras Michel, a founding member of the Fugees, has done it—getting his dousing in the center ...

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

User comments : 0