title: Risk factors for death in elderly patients with facial fractures secondary to falls.
abstract: BACKGROUND
  Craniomaxillofacial trauma is associated with severe injuries and disability. There are no recent reports analyzing the demographics of facial trauma in elderly patients. Our objective was to review the demographics, outcomes, and risk factors associated with death in elderly patients with facial fractures in a single-institution level I trauma center.
  
  
  METHODS
  We performed a retrospective review of the University of Pittsburgh Medical Center Trauma Registry from January 1999 to December 2008 in an institutional review board-approved protocol. The search query included all types of craniofacial trauma using International Classification of Diseases, Ninth Revision coding. A χ test was used for analyzing categorical data. Continuous data were analyzed using unpaired t-test or analysis of variance. Logistic regressions were done to determine odds ratio (OR) for death. P = 0.05 was deemed significant.
  
  
  RESULTS
  A total of 16,528 patients with facial trauma were identified. Of these, 4536 patients had falls. Among the falls, 1020 patients had facial fractures. Finally, 460 patients were younger than 65 years, and 560 were older than 65 years. The variable with the highest odds for mortality in patients with facial fractures was intensive care unit admission (OR, 13.1), followed by acute renal failure (OR, 10.3), medical history of myocardial infarction (OR, 5.1), coagulopathy (OR, 4.78), age older than 65 years (OR, 4.13), acute respiratory failure (OR, 3.55), Abbreviated Injury Scale score greater than 3 at the head (OR, 3.5), congestive heart failure (OR, 2.64), history of cardiac surgery (OR, 2.4), and vault skull fracture (OR, 2.35).
  
  
  CONCLUSIONS
  Craniofacial trauma is a serious condition in the elderly. Associated injuries are demonstrated to have a deleterious effect on survival. Recognition of these risk factors is likely to promote the development of preventive measurements to decrease fatal outcomes.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. Clavja@upmc.edu
authors.forename: Julio A
authors.initials: JA
authors.lastname: Clavijo-Alvarez
authors.forename: Frederic W-B
authors.initials: FW
authors.lastname: Deleyiannis
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Peitzman
authors.forename: Mazen S
authors.initials: MS
authors.lastname: Zenati
mesh_terms: D015998:Abbreviated Injury Scale; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015897:Comorbidity; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000401:mortality*