SA2 - Factors Associated With Patient-Initiated Postoperative Communication Following Oral and Maxillofacial Surgery

Abstract: Postoperative patient-initiated communication has become an important component of recovery after oral and maxillofacial surgery, yet the factors associated with these interactions remain incompletely understood. The purpose of this study was to identify demographic, clinical, psychosocial, and treatment-related factors associated with patient-initiated communication within 30 days of surgery and to distinguish factors associated with clinically actionable communication. The investigators implemented a retrospective cohort study of 625 patients treated in a university-based oral and maxillofacial surgery service at a level 1 trauma center. Patient-initiated communications were categorized as prescription-related, wound or surgical concern, or scheduling or paperwork related; prescription-related and wound or surgical concerns were grouped as clinical communication. Descriptive statistics were calculated, and bivariate comparisons were performed using chi-square tests and independent-samples t-tests. Variables significant on bivariate testing were entered into logistic regression to identify independent predictors of communication within 30 days. Overall, 319 of 625 patients (51.0%) initiated postoperative communication. Most contacts were scheduling or paperwork related (169, 52.9%), followed by wound or surgical concerns (105, 32.9%) and prescription-related questions (45, 14.1%). Most communications were therefore nonclinical, and only 27.4% required clinical intervention. On bivariate analysis, patients who initiated communication were older (48.4 vs 44.0 years, P = .01), more likely to be female (58.6% vs 46.2%, P < .01), commercially insured (62.4% vs 45.5%, P < .01), prescribed narcotics at discharge (54.5% vs 37.0%, P < .01), treated in ambulatory surgery (58.0% vs 44.2%, P < .01), and to have undergone TMJ surgery (67.7% vs 50.1%, P = .04). In multivariable analysis, older age (OR 1.01, 95% CI: 1.00-1.02; P < .01), female sex (OR 1.45, 95% CI: 1.02-2.07; P = .04), commercial insurance (OR 2.01, 95% CI: 1.40-2.89; P < .01), narcotic prescription (OR 1.86, 95% CI: 1.19-2.91; P < .01), and ambulatory surgery (OR 1.45, 95% CI: 1.03-2.04; P = .04) were independently associated with communication within 30 days. Clinically actionable communication was more often associated with psychiatric history and female sex. Patient-initiated postoperative communication is common and appears to be driven more by patient and discharge-related factors than by procedural complexity alone. These findings support targeted discharge education, proactive follow-up, and additional support for patients at increased risk for frequent or clinically significant postoperative communication.


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