"Predictors of Increased Mortality in Facial Trauma Patients Over 65"

The overall rate of death in facial trauma patients is <1%; however, this figure increases significantly in the elderly, with estimates as high as 15 times greater than the general population. While the majority of facial fractures occur in young males, there is a dearth of literature regarding morbidity and mortality trends associated with elderly populations. Here, our group analyzes the complication rates and mortality data of elderly patients receiving care for facial fractures. This study aims to identify prominent risk factors contributing to increased rates of mortality in this patient demographic.

Institutional Review Board (IRB) approval was obtained from Loyola University Medical Center to perform a retrospective chart review of patients aged 65 and older who presented with facial trauma from 2017 to 2021. Excluded patients were those with index facial trauma before 2017 who followed up during the study period and those without postoperative data or lost to follow-up.

Two hundred thirty-eight patients met the inclusion criteria; the mean age at the time of facial trauma was 76. Of the included patients, 15% (n=36) expired during the analyzed follow-up period. Results indicate that a history of cerebral vascular accident (CVA) or malignancy with metastases before facial trauma were associated with significantly lower survival rates (P=0.01, 0.002, respectively). In the post-trauma follow-up period, incidence of CVA (P=0.008), malignancy with metastases (P=0.01), and diagnosis of peptic ulcer disease (postfacial trauma) (P=0.01) were all associated with significantly lower survival rates. The use of acetaminophen at any time was associated with significantly higher survival rates (P=0.001). There was no significant difference in mortality trends when comparing race or sex.

This study aimed to look at survival rates in elderly facial trauma patients. By identifying existing risks in older adults presenting with facial trauma, the authors hope to optimize management strategies in the treatment of facial trauma and proactively identify patients who may be at a disproportionately high risk of mortality from their injury.