Can Frailty Indices Predict Surgical Risk in Open Reduction and Fixation of Facial Fractures?

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Outcomes Research
• Patient Safety

Background:

• Facial fracture repair is common, with postoperative complications impacting patient recovery.
• Accurate prediction of complications is crucial for optimizing surgical planning and patient management.

Purpose of the Study:

• To evaluate the predictive power of the modified Charlson Comorbidity Index (mCCI) and the modified Frailty Index (mFI-5) for 30-day postoperative complications following open reduction of facial fractures.
• To compare the efficacy of mCCI and mFI-5 against traditional risk factors.

Main Methods:

• Retrospective analysis of the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database (2013-2018).
• Inclusion of patients undergoing open reduction for facial fractures.
• Calculation of mCCI and mFI-5 scores based on extracted patient data including demographics, comorbidities, and American Society of Anesthesiologists (ASA) class.

Main Results:

• The American Society of Anesthesiologists (ASA) class ≥3 (OR=3.34), ≥2 comorbidities (OR=2.78), mCCI score ≥2 (OR=2.19), and mFI-5 score ≥1 (OR=1.96) were significant predictors of overall 30-day complications and severity.
• Smoking status (OR=1.56) and ASA class ≥3 (OR=2.40) predicted surgical site infections (SSI).
• mFI-5 ≥1 predicted hospital readmission; BMI and age had minimal impact on overall complications.

Conclusions:

• The mCCI and mFI-5 serve as valuable tools for predicting 30-day complications and severity in patients undergoing open reduction of facial fractures.
• These indices can inform clinical decision-making and enhance patient care strategies.
• Smoking status is identified as a risk factor for SSIs in this patient population.