title: Among Patients With Facial Fractures, Geriatric Patients Have an Increased Risk for Associated Injuries.
abstract: OBJECTIVE
  It is hypothesized that facial trauma-associated injuries (AIs) are more frequent and severe in elderly than in younger adult patients. The purpose of this study was to determine the occurrence of, reasons for, and severity of AI in geriatric facial fractures and to compare the differences between geriatric and younger adult patients.
  
  
  METHODS
  Two patient cohorts were included in this cross-sectional retrospective study. Geriatric patients were at least 65 years old (n = 117) and younger controls were 20 to 50 years old (n = 136). The main predictor was age, the primary outcome was AI, and secondary outcomes were affected organ system, multiple AIs, polytrauma, and mortality during hospitalization. The other explanatory variables were gender, trauma mechanism, and type of facial fracture. Statistical methods included χ(2) tests, risk analyses with 2 × 2 table, and logistic regression analyses.
  
  
  RESULTS
  AIs were significantly more common in geriatric patients (44.0%) than in younger controls (25.0%; P < .001). Also, multiple AIs (P = .003), polytrauma (P = .039), mortality (P = .008), limb injuries (P = .005), and spine injuries (P = .041) were significantly more common in the elderly. In the risk analyses, geriatric patients had a 1.8-fold risk for AI, a 2.6-fold risk for multiple AIs, and a 2.2-fold risk for polytrauma.
  
  
  CONCLUSIONS
  AIs are much more frequent and severe in geriatric patients, and the elderly die more often of their injuries. The results emphasize that elderly patients require specific attention and multi-professional collaboration in the diagnosis and sequencing of trauma treatment.
authors.affiliation: Resident, Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: miika.toivari@helsinki.fi.
authors.forename: Miika
authors.initials: M
authors.lastname: Toivari
authors.affiliation: Professor, Departments of Health, Functional Capacity and Welfare and Environmental Health, National Institute for Health and Welfare, Helsinki/Kuopio, Finland; Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Anna Liisa
authors.initials: AL
authors.lastname: Suominen
authors.affiliation: Professor, Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Christian
authors.initials: C
authors.lastname: Lindqvist
authors.affiliation: Docent, Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Thorén
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications*; D012189:Retrospective Studies; D012306:Risk; D012887:Skull Fractures / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy