Time-to-operation delays and in-hospital complications in operative facial trauma: A national analysis.
Am J Otolaryngol
; 45(2): 104148, 2024.
Article
en En
| MEDLINE
| ID: mdl-38101139
ABSTRACT
BACKGROUND:
Management of facial fractures is variable. Understanding how time to operative management impacts outcomes can help standardize practice.METHODS:
Retrospective analysis of the ACS Trauma Quality Improvement Program (TQIP) database between 2016 and 2019. Adult patients with operative facial fractures were isolated by ICD-10 procedure codes, and further stratified by fracture location, including the mandible, orbit, maxilla, zygoma, and frontal bone. Multivariable logistic regression was conducted to predict in-hospital complications (both surgical and systemic complications) adjusting for time-to-operation, comorbidities, fracture location, AIS, and demographics.RESULTS:
1678 patients with operative facial fractures were identified. The median time-to-operation was 2 days (IQR 1.0-2.0 days). Most patients only had one operative fracture (95 %) and orbital fracture was the most common (44 %). The overall complication rate was higher for those operated after 2 days compared to those operated between 1 and 2 days and within 24 h (2.8 % vs 0.6 % vs 0.7 %; p < 0.001). Patients who were operated on after 48 h exhibited an increased risk of any complication (OR 4.72, 95 % CI 1.49-16.6, p = 0.010) on multivariable models.CONCLUSION:
Delays in the management of facial fractures are associated with more in-hospital complications. However, the incidence of short-term postoperative complications remains low. Injury characteristics are the primary predictor of delays in operation, however Hispanic patients independently experienced delays in care.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Fracturas Craneales
/
Traumatismos Faciales
/
Herida Quirúrgica
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Am J Otolaryngol
Año:
2024
Tipo del documento:
Article