Factors Influencing Postoperative Recovery Time and Development of a Predictive Model in Patients Undergoing Orthognathic Surgery

OBJECTIVE: To investigate factors associated with delayed postoperative recovery after orthognathic surgery and to develop a clinically interpretable predictive model for recovery time. METHODS: This retrospective study included 106 patients who underwent orthognathic surgery between 2024 and 2026. Delayed recovery was defined as an overall recovery time >60 days. Candidate predictors included age, double-jaw surgery, operation time, intraoperative blood loss, postoperative pain score on day 1, swelling score on day 3, and postoperative complications. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors and construct a prediction model. Model performance was evaluated using receiver operating characteristic analysis, calibration assessment, and decision-curve analysis. RESULTS: Among the 106 patients, 39 (36.8%) experienced delayed recovery. Univariable analysis showed that double-jaw surgery, longer operation time, greater blood loss, higher postoperative pain score, and increased swelling score were significantly associated with delayed recovery (all P < 0.05). In multivariable analysis, postoperative pain remained an independent predictor (adjusted OR: 2.11; 95% CI: 1.18-3.79; P = 0.012). Blood loss and operation time showed clinically relevant trends toward significance. The prediction model demonstrated good discrimination with an area under the curve of 0.880. Calibration analysis showed acceptable agreement between predicted and observed outcomes, and decision-curve analysis suggested favorable clinical utility. CONCLUSIONS: Delayed recovery after orthognathic surgery was associated with operative burden and early postoperative symptom severity. The proposed prediction model demonstrated good predictive performance and may help support individualized perioperative counseling and postoperative management after external validation.