Facial Fractures After Geriatric Ground-Level Falls Are a Marker of Functional Decline and Warrant Trauma Center Admission
Ground-level falls (GLFs) are a frequent source of injury in the geriatric population. Facial fractures (FFs) are one subsequent injury that can occur and may be an important marker of functional decline. We conducted a retrospective analysis over a 6-year period of patients 65 years and older susta...
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| Veröffentlicht in: | The American surgeon 2020-10, Vol.86 (10), p.1302-1306 |
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| creator | St Hilaire, Cameron Johnson, Arianne Loseth, Caitlin Alipour, Hamid Faunce, Nick Kaminski, Stephen Sharma, Rohit |
| description | Ground-level falls (GLFs) are a frequent source of injury in the geriatric population. Facial fractures (FFs) are one subsequent injury that can occur and may be an important marker of functional decline. We conducted a retrospective analysis over a 6-year period of patients 65 years and older sustaining one or more FFs due to a GLF (n = 28). Demographics, comorbidities, FF patterns, concomitant injuries, procedures, and outcomes were analyzed. The mean age was 80.0 ± 8.2 years, 64% were male, 12 patients (43%) were on oral anticoagulants prior to injury, and mean injury severity score was 8.3 ± 7.0. Five patients (18%) had LeFort fractures (1 with LeFort I, 4 with LeFort II), and 5 (18%) had isolated mandible fractures (2 were bilateral). Nearly half of all patients suffered neurological injury (concussion: 18%, intracranial hemorrhage: 29%). Average hospital length of stay (LOS) was 4.0 ± 2.9 days. Eight patients (29%) required intensive care unit (ICU) admission with an average ICU-LOS of 2.8 ± 1.2 days. Surgical management was required in 4 patients (14%). More than half of the patients returned home (54%), 25% were discharged to a skilled nursing facility, 4% to rehabilitation, 7% to hospice, and 7% expired. Nearly one-third of patients required discharge to a higher level of care facility than their location prior to injury. GLF-induced FFs are often associated with significant injuries and serve as an indicator of functional decline. These injuries warrant trauma center admission for comprehensive evaluation and management. |
| doi_str_mv | 10.1177/0003134820964228 |
| format | Article |
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Facial fractures (FFs) are one subsequent injury that can occur and may be an important marker of functional decline. We conducted a retrospective analysis over a 6-year period of patients 65 years and older sustaining one or more FFs due to a GLF (n = 28). Demographics, comorbidities, FF patterns, concomitant injuries, procedures, and outcomes were analyzed. The mean age was 80.0 ± 8.2 years, 64% were male, 12 patients (43%) were on oral anticoagulants prior to injury, and mean injury severity score was 8.3 ± 7.0. Five patients (18%) had LeFort fractures (1 with LeFort I, 4 with LeFort II), and 5 (18%) had isolated mandible fractures (2 were bilateral). Nearly half of all patients suffered neurological injury (concussion: 18%, intracranial hemorrhage: 29%). Average hospital length of stay (LOS) was 4.0 ± 2.9 days. Eight patients (29%) required intensive care unit (ICU) admission with an average ICU-LOS of 2.8 ± 1.2 days. Surgical management was required in 4 patients (14%). More than half of the patients returned home (54%), 25% were discharged to a skilled nursing facility, 4% to rehabilitation, 7% to hospice, and 7% expired. Nearly one-third of patients required discharge to a higher level of care facility than their location prior to injury. GLF-induced FFs are often associated with significant injuries and serve as an indicator of functional decline. These injuries warrant trauma center admission for comprehensive evaluation and management.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/0003134820964228</identifier><identifier>PMID: 33074742</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Accidental Falls ; Aged ; Aged, 80 and over ; Anticoagulants ; Coma ; Comorbidity ; Concussion ; Demographics ; Demography ; Falls ; Female ; Fractures ; Geriatrics ; Hemorrhage ; Hospitalization - statistics & numerical data ; Humans ; Injuries ; Injury analysis ; Injury Severity Score ; Intensive care ; Length of Stay - statistics & numerical data ; Male ; Mandible ; Markers ; Mortality ; Nursing ; Osteoporosis ; Patients ; Population ; Registries ; Rehabilitation ; Retrospective Studies ; Sinuses ; Skull Fractures - etiology ; Skull Fractures - therapy ; Trauma ; Trauma Centers</subject><ispartof>The American surgeon, 2020-10, Vol.86 (10), p.1302-1306</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-ce6acb3d0a469649dc911b9249e31c58e19c32aa3a9cd4ca7a3a102509ff64933</citedby><cites>FETCH-LOGICAL-c365t-ce6acb3d0a469649dc911b9249e31c58e19c32aa3a9cd4ca7a3a102509ff64933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0003134820964228$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0003134820964228$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33074742$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>St Hilaire, Cameron</creatorcontrib><creatorcontrib>Johnson, Arianne</creatorcontrib><creatorcontrib>Loseth, Caitlin</creatorcontrib><creatorcontrib>Alipour, Hamid</creatorcontrib><creatorcontrib>Faunce, Nick</creatorcontrib><creatorcontrib>Kaminski, Stephen</creatorcontrib><creatorcontrib>Sharma, Rohit</creatorcontrib><title>Facial Fractures After Geriatric Ground-Level Falls Are a Marker of Functional Decline and Warrant Trauma Center Admission</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>Ground-level falls (GLFs) are a frequent source of injury in the geriatric population. Facial fractures (FFs) are one subsequent injury that can occur and may be an important marker of functional decline. We conducted a retrospective analysis over a 6-year period of patients 65 years and older sustaining one or more FFs due to a GLF (n = 28). Demographics, comorbidities, FF patterns, concomitant injuries, procedures, and outcomes were analyzed. The mean age was 80.0 ± 8.2 years, 64% were male, 12 patients (43%) were on oral anticoagulants prior to injury, and mean injury severity score was 8.3 ± 7.0. Five patients (18%) had LeFort fractures (1 with LeFort I, 4 with LeFort II), and 5 (18%) had isolated mandible fractures (2 were bilateral). Nearly half of all patients suffered neurological injury (concussion: 18%, intracranial hemorrhage: 29%). Average hospital length of stay (LOS) was 4.0 ± 2.9 days. Eight patients (29%) required intensive care unit (ICU) admission with an average ICU-LOS of 2.8 ± 1.2 days. Surgical management was required in 4 patients (14%). More than half of the patients returned home (54%), 25% were discharged to a skilled nursing facility, 4% to rehabilitation, 7% to hospice, and 7% expired. Nearly one-third of patients required discharge to a higher level of care facility than their location prior to injury. GLF-induced FFs are often associated with significant injuries and serve as an indicator of functional decline. These injuries warrant trauma center admission for comprehensive evaluation and management.</description><subject>Accidental Falls</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants</subject><subject>Coma</subject><subject>Comorbidity</subject><subject>Concussion</subject><subject>Demographics</subject><subject>Demography</subject><subject>Falls</subject><subject>Female</subject><subject>Fractures</subject><subject>Geriatrics</subject><subject>Hemorrhage</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Injury Severity Score</subject><subject>Intensive care</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Mandible</subject><subject>Markers</subject><subject>Mortality</subject><subject>Nursing</subject><subject>Osteoporosis</subject><subject>Patients</subject><subject>Population</subject><subject>Registries</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Sinuses</subject><subject>Skull Fractures - 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Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>St Hilaire, Cameron</au><au>Johnson, Arianne</au><au>Loseth, Caitlin</au><au>Alipour, Hamid</au><au>Faunce, Nick</au><au>Kaminski, Stephen</au><au>Sharma, Rohit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Facial Fractures After Geriatric Ground-Level Falls Are a Marker of Functional Decline and Warrant Trauma Center Admission</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2020-10</date><risdate>2020</risdate><volume>86</volume><issue>10</issue><spage>1302</spage><epage>1306</epage><pages>1302-1306</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Ground-level falls (GLFs) are a frequent source of injury in the geriatric population. Facial fractures (FFs) are one subsequent injury that can occur and may be an important marker of functional decline. We conducted a retrospective analysis over a 6-year period of patients 65 years and older sustaining one or more FFs due to a GLF (n = 28). Demographics, comorbidities, FF patterns, concomitant injuries, procedures, and outcomes were analyzed. The mean age was 80.0 ± 8.2 years, 64% were male, 12 patients (43%) were on oral anticoagulants prior to injury, and mean injury severity score was 8.3 ± 7.0. Five patients (18%) had LeFort fractures (1 with LeFort I, 4 with LeFort II), and 5 (18%) had isolated mandible fractures (2 were bilateral). Nearly half of all patients suffered neurological injury (concussion: 18%, intracranial hemorrhage: 29%). Average hospital length of stay (LOS) was 4.0 ± 2.9 days. Eight patients (29%) required intensive care unit (ICU) admission with an average ICU-LOS of 2.8 ± 1.2 days. Surgical management was required in 4 patients (14%). More than half of the patients returned home (54%), 25% were discharged to a skilled nursing facility, 4% to rehabilitation, 7% to hospice, and 7% expired. Nearly one-third of patients required discharge to a higher level of care facility than their location prior to injury. GLF-induced FFs are often associated with significant injuries and serve as an indicator of functional decline. These injuries warrant trauma center admission for comprehensive evaluation and management.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>33074742</pmid><doi>10.1177/0003134820964228</doi><tpages>5</tpages></addata></record> |
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| subjects | Accidental Falls Aged Aged, 80 and over Anticoagulants Coma Comorbidity Concussion Demographics Demography Falls Female Fractures Geriatrics Hemorrhage Hospitalization - statistics & numerical data Humans Injuries Injury analysis Injury Severity Score Intensive care Length of Stay - statistics & numerical data Male Mandible Markers Mortality Nursing Osteoporosis Patients Population Registries Rehabilitation Retrospective Studies Sinuses Skull Fractures - etiology Skull Fractures - therapy Trauma Trauma Centers |
| title | Facial Fractures After Geriatric Ground-Level Falls Are a Marker of Functional Decline and Warrant Trauma Center Admission |
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