Is the Mandible Injury Severity Score a valid measure of mandibular injury severity?

Publication date: Available online 10 December 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Rodney N. Nishimoto, Thomas B. Dodson, Melanie S. Lang

Abstract

Purpose

Developing a valid method for assessing mandibular injury severity may permit standardized comparisons of treatment-specific outcomes between and among various mandibular fracture studies. The study purpose was to assess the validity of the Mandible Injury Severity Score (MISS) developed by Shetty et al by measuring the association between the MISS and postoperative complications, operative time, and length of hospital stay (LOS) following operative treatment of isolated mandible fractures.¹

Materials and Methods

The investigators designed and implemented a retrospective cohort study and enrolled a sample derived from patients treated for isolated mandible fractures at Harborview Medical Center by the oral and maxillofacial surgery (OMS) service between June 2012 through December 2016. The primary predictor variable was the MISS. The primary outcome variable was postoperative complication (yes or no). Secondary outcome variables were operative time and LOS. Descriptive, bivariate, and multiple logistic regression statistics were computed to measure the association between the MISS and postoperative complications. The level of statistical significance was set at a P ≤0.05.

Results

The study sample was composed of 415 subjects with a mean age of 32.7±14.3 and 80% of subjects were male. The average MISS was 13.4±3.5 (range 6-25). The postoperative complication rate was 21%. The average MISS was significantly higher in subjects with postoperative complications than in subjects without complications (16.3±3.3 vs 12.6±3.1; P<.001). In the adjusted model, postoperative complications were significantly associated with increasing MISS (OR=1.4; 95% CI 1.3-1.6; P<.001) and open treatment (OR=7.6; 95% CI 1.6-35.6; P=0.01). MISS was positively correlated with operative time (r=.529; P<.001) and LOS (r=.114; P=0.02).

Conclusion

The results of this study suggest that the Mandible Injury Severity Score may be a valid measure of mandibular injury severity as evidenced by the positive correlation among the MISS and postoperative complications, duration of operation, and LOS.

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