Factors associated with complications of submental intubation in 339 patients with facial fractures: A German retrospective cohort study
Issued Date
2023-04-01
Resource Type
eISSN
24687855
Scopus ID
2-s2.0-85143523250
Pubmed ID
36400390
Journal Title
Journal of Stomatology, Oral and Maxillofacial Surgery
Volume
124
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Stomatology, Oral and Maxillofacial Surgery Vol.124 No.2 (2023)
Suggested Citation
Pitak-Arnnop P., Tangmanee C., Subbalekha K., Sirintawat N., Urwannachotima N., Auychai P., Messer-Peti R., Meningaud J.P., Neff A. Factors associated with complications of submental intubation in 339 patients with facial fractures: A German retrospective cohort study. Journal of Stomatology, Oral and Maxillofacial Surgery Vol.124 No.2 (2023). doi:10.1016/j.jormas.2022.11.008 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/81810
Title
Factors associated with complications of submental intubation in 339 patients with facial fractures: A German retrospective cohort study
Other Contributor(s)
Abstract
Purpose: For nearly four decades, submental intubation (SI) has been introduced and employed to avoid tracheostomy in facial trauma cases where nasal/oral intubation is infeasible or associated with possible risks. The purposes of this study were to estimate the frequency and to identify variables associated with complications of SI (CSI). Methods: The authors organised a retrospective cohort study and enrolled a group of patients with facial trauma and SI during a seven-year interval at two German level one trauma centres where SI has routinely been used in complex facial trauma cases. The predictor variables included demographic, medical, dental, fracture-related, operative, and postoperative parameters. The outcome variable was CSI. We used descriptive, bivariate, and multivariate analyses at the 0.05 significant level. Results: The sample included 339 patients (24.5% females, 9.4% had complications) with an average age of 58.2 ± 12.0 years (range, 17–89). Bivariate analyses revealed nine significant variables. However, forward stepwise multiple logistic regression modelling identified three variables statistically associated with CSI: smoking (OR, 691.8; 95% CI, 75.9 to 6303.9; P < 0.0001; number needed to harm [NNH], 6), moderate to high gingival inflammation (OR, 786.7; 95% CI, 66 to 9378.9; P = 0.002; NNH, 12), and postoperative use of chlorhexidine mouthwash (OR, 0.03; 95% CI, 0.001 to 0.77; P = 0.0003; number needed to treat [NNT], 2). Conclusions: smokers and subjects with gingivitis were more likely to experience CSI. Postoperative chlorhexidine rinsing was the potentially modifiable, albeit low-OR, factor. These findings could help to draw an effective guideline against the CSI.