TY  - JOUR
PY  - 2019//
TI  - The association between frailty status and odontoid fractures following traumatic falls: investigation of varying injury mechanisms among 70 elderly odontoid fracture patients
JO  - Journal of Orthopaedic Trauma
A1  - Alas, Haddy
A1  - Segreto, Frank A.
A1  - Chan, Hoi Ying
A1  - Brown, Avery E.
A1  - Pierce, Katherine E.
A1  - Bortz, Cole A.
A1  - Horn, Samantha R.
A1  - Varlotta, Christopher G.
A1  - Baker, Joseph F.
A1  - Passias, Peter G.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0890-5339
UR  - http://dx.doi.org/10.1097/BOT.0000000000001597
ID  - ref1
ER  -