ABSTRACT
PURPOSE: Mandibular osteoradionecrosis (ORN) can occur in patients post-radiation therapy. This study assessed the incidence of ORN in the setting of adjunctive hyperbaric oxygen therapy (HBO2) and sought to identify risk factors that may predispose to its development. METHODS: A retrospective chart review was completed on patients with a history of radiation therapy to the head and neck who underwent HBO2 prior to and immediately following dental extractions between January 1, 1995, and December 31, 2005, in the hyperbaric medicine unit. RESULTS: The incidence of ORN in 40 patients immediately following completion of HBO was 0%. Available follow-up longer than six months after completion of HBO2 on 19 of these patients showed an incidence of ORN increased to 15.8%. None of the considered risk factors for development of ORN reach statistical significance. CONCLUSION: The incidence of ORN at the completion of HBO2 was less than previously reported incidences between 1.5%-4.2%. However, long-term follow-up indicated a much higher incidence of 15.8%. The difference in incidence of ORN immediately upon completion of HBO2 approximately two weeks after dental extractions compared to that at least six months later identifies a need for more long-term follow-up of these patients following their dental extractions.
Subject(s)
Hyperbaric Oxygenation , Jaw Diseases/epidemiology , Osteoradionecrosis/epidemiology , Tooth Extraction , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Head and Neck Neoplasms/radiotherapy , Humans , Hyperbaric Oxygenation/methods , Incidence , Jaw Diseases/prevention & control , Male , Middle Aged , New York/epidemiology , Oral Hygiene , Osteoradionecrosis/prevention & control , Retrospective Studies , Statistics, Nonparametric , Time Factors , Treatment Outcome , Young AdultABSTRACT
Accurate predictions of patient length of stay (LOS) in the hospital can effectively manage hospital resources and increase efficiency of patient care. A study was done to assess emergency medicine physicians' ability of predicting the LOS of patients who enter the hospital through the ER. Results indicate that EM physicians are relatively accurate with their pediatric patients than any other age groups. In addition, as actual hospital LOS increases, the prediction accuracy decreases. Possible reasons may be due increasing medical complications associated with increasing age and this may lead to overall longer stays. Other variables such as the admitted service of the patient are not statistically significant in predicting LOS in this study. Future studies should be done in order to determine other variables that may affect LOS predictions.
