@article{ref1,
title="The association between frailty status and odontoid fractures following traumatic falls: investigation of varying injury mechanisms among 70 elderly odontoid fracture patients",
journal="Journal of Orthopaedic Trauma",
year="2019",
author="Alas, Haddy and Segreto, Frank A. and Chan, Hoi Ying and Brown, Avery E. and Pierce, Katherine E. and Bortz, Cole A. and Horn, Samantha R. and Varlotta, Christopher G. and Baker, Joseph F. and Passias, Peter G.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: Determine significant associations between patient frailty status and odontoid fractures across common traumatic mechanisms of injuries (MOI) in the elderly. <br><br>DESIGN: Retrospective review. SETTING: Single, academic-affiliated hospital with full surgical servicesPatients/Participants: Patients >65 years old with traumatic odontoid fracture were included. INTERVENTION: Non-operative management (soft/hard collar, halo, traction tongs, minerva) and/or operative fixation. MAIN OUTCOME MEASUREMENTS: mFI, MOI, concurrent injuries, inpatient LOS, reoperation and mortality rates. <br><br>RESULTS: 70 patients were included (80.6±8.5yrs, 60%F, 88% European, 10% Maori/Pacific, 1.4% Asian, CCI 5.3± 2.2, mFI 0.21±0.15). The most common MOIs were Falls (74.3%), high speed MVAs (17.1%), low speed MVAs (5.7%), and pedestrian vs car (2.9%). Patients with traumatic falls exhibited significantly higher mFI scores (0.25) compared to low speed MVAs (0.16), high speed MVAs (0.08), and pedestrian vs car (0.01) (p=0.003). Twenty-seven patients with odontoid fractures were Frail, 33 were Pre-frail, and 10 were Robust. 92% of Frail patients had traumatic fall as their MOI, as opposed to 73% of Pre-frail and 30% of Robust patients (p<0.001). Pre-frail and Frail patients were 4.3 times more likely than Robust patients to present with odontoid fractures via traumatic fall (OR: 4.33 [1.47-12.75], p=0.008), and frailty increased likelihood of reoperation (OR: 4.2 [1.2-14.75], p=0.025) and extended LOS (OR: 5.71 [1.05-10.37], p=0.017). Frail patients had the highest 30-day (p=0.017) and 1-year mortality (p<0.001) compared to other groups. <br><br>CONCLUSION: Patients with traumatic odontoid fracture from falls were significantly more frail in comparison to any other MOI, with worse short and long-term outcomes. LEVEL OF EVIDENCE: Level III Retrospective Cohort Study.<p /> <p>Language: en</p>",
language="en",
issn="0890-5339",
doi="10.1097/BOT.0000000000001597",
url="http://dx.doi.org/10.1097/BOT.0000000000001597"
}