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What are the Risk Factors for Mortality Among Patients Who Suffer Le Fort III Fractures?
Dani Stanbouly1, Michael Baron2, Syed Salim Abdul-Wasay3
1Dental Student, Columbia University, College of Dental Medicine, New York, NY.
Summary
Le Fort III fractures are severe, and this study identified key mortality risk factors. Female sex, uninsured status, cranial vault, and upper cervical fractures significantly increase mortality risk in these patients.
Area of Science:
- Trauma Surgery
- Orthopedic Surgery
- Public Health
Background:
- Le Fort III fractures represent the most severe type of midface fractures.
- These severe fractures are associated with significant adverse clinical outcomes and mortality.
- Identifying specific risk factors for mortality is crucial for improving patient management and outcomes.
Purpose of the Study:
- To identify independent risk factors associated with mortality in patients sustaining Le Fort III fractures.
- To analyze demographic, injury-related, and treatment-related variables predicting mortality.
Main Methods:
- Retrospective cohort study utilizing the 2016-2018 National Inpatient Sample.
- Inclusion criteria: isolated Le Fort III fractures; exclusion: non-head/neck bone or organ injuries.
- Primary outcome: mortality; analysis using relative risk and P values < .05.
Main Results:
- A total of 559 patients were analyzed; 2.68% (15 patients) died.
- Independent risk factors for mortality included female sex (RR 7.14), uninsured status (23x increased risk), weekend admissions (8x increased risk), cranial vault fractures (OR 7.24), and upper cervical fractures (OR 63.27).
- Skull base fractures, subdural hemorrhage, subarachnoid hemorrhage, and neck vascular injuries also increased mortality risk.
Conclusions:
- Cranial vault and skull base fractures, not intracranial injury alone, are significant risk factors for mortality.
- Female sex and lack of insurance independently increase mortality risk in Le Fort III fracture patients.
- Targeted interventions and closer monitoring for high-risk groups are warranted.
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