Impact of Age on Surgical Outcomes Following Mandible Fracture Repair

Laryngoscope. 2023 Feb;133(2):287-293. doi: 10.1002/lary.30208. Epub 2022 May 31.

Abstract

Objectives: Open repair of mandibular fractures are frequently performed surgical procedures. Increasing rates of such fractures are seen in older adults following falls. This study assesses the impact of older age on early complications following mandible fracture repair.

Study design: Retrospective analysis of national registry.

Methods: The 2013-2018 National Surgical Quality Improvement Program database was queried for all cases of open mandible fracture repair and cases were categorized into younger (18-40), middle (41-65), and older (>65) age cohorts. Demographics and comorbidities were compared between the age groups. Rates of surgical, medical, and wound complications within 30-days of surgery were determined. Multivariable logistic analyses were performed to assess the relationship between age and complications.

Results: Altogether, 1818 cases were included for analysis, of which 1269 (69.8%) were younger, 459 (25.2%) were middle, and 90 (5.0%) were older age. Increased rates of complications were seen in the older groups, including unplanned reoperation, unplanned readmission, wound disruption, and medical complications (p < 0.01). On unadjusted analysis, the older (>65) age group had an increased odds of experiencing a complication compared to the younger (18-40) group (OR: 4.19, p < 0.001). The older age group continued to have a significantly increased odds of medical complications after multivariable adjustment (adjusted OR: 8.64, p < 0.001).

Conclusions: On this analysis of a national database, advanced age was associated with an increased frequency of early postoperative complications following open mandibular fracture repair. Following multivariable adjustment, advanced age continued to be associated with increased odds of postoperative medical complications within 30 days of surgery.

Level of evidence: 3 Laryngoscope, 133:287-293, 2023.

Keywords: age; complications; mandible fracture; outcomes; surgery.

MeSH terms

  • Aged
  • Comorbidity
  • Humans
  • Infant
  • Mandible
  • Mandibular Fractures* / surgery
  • Patient Readmission
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome