Survey of trauma patients requiring maxillofacial intervention, ages 56 to 91 years, with length of stay analysis.
OBJECTIVE
The purpose of this study was to analyze trauma patients, ages 55 and older, sustaining multiple injuries including maxillofacial trauma. Factors influencing length of intensive care unit stay (ICUS) and length of total hospital stay were delineated and examined to determine if specific causes of increased length of stay could be elucidated, and, once known, if these causes could translate into recommendations tailored to the oral and maxillofacial surgery trauma practice.


METHODS
One hundred ninety-six patients, 55 years of age or older, who received either consultation alone, or consultation with surgical treatment, by oral and maxillofacial surgeons, from January 1991 to August 1998 were included in this study. Variables of interest included location of traumatic event, mechanism of injury, patient age and gender, comorbidities on presentation, Injury Severity Score (ISS), specific injuries incurred, ICUS, length of hospital stay (LOS), surgical interventions, and disposition.


RESULTS
Complications were the statistically significant factor determining length of ICU stay. ICUS, complications incurred, and ISS were the important predictors of total LOS. The significant complications affecting LOS were infectious, respiratory, and hematologic complications.


CONCLUSIONS
The number of complications the patient incurs after an injury can predict length of ICUS. Length of ICUS, ISS, and number of complications incurred were the strongest predictors for total length of hospital stay. Other variables, including age, gender, living or dead, blunt versus penetrating injury, ISS, fracture site (skull, midface, or lower face), and comorbidities on presentation were not statistically significant in this patient population. Infectious, respiratory, and hematologic complications were the complications most closely correlated with increasing length of ICUS and total hospital stay.
Gray
Edward
E
Oral and Maxillofacial Surgery, Oregon Health Sciences University and Legacy Emanuel Hospital and Health Center, Portland, USA.
Dierks
Eric
E
Homer
Louis
L
Smith
Fredric
F
Potter
Bryce
B
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003625:Data Collection; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008446:Maxillofacial Injuries / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology*; D019838:Neck Injuries / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D009922:Oregon / Q000453:epidemiology; D011379:Prognosis; D012044:Regression Analysis; D012887:Skull Fractures / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices