Facial Fractures After Geriatric Ground-Level Falls Are a Marker of Functional Decline and Warrant Trauma Center Admission

Abstract

Ground-level falls (GLFs) are a frequent source of injury in the geriatric population. Facial fractures (FFs) are one subsequent injury that can occur and may be an important marker of functional decline. We conducted a retrospective analysis over a 6-year period of patients 65 years and older sustaining one or more FFs due to a GLF (n = 28). Demographics, comorbidities, FF patterns, concomitant injuries, procedures, and outcomes were analyzed. The mean age was 80.0 ± 8.2 years, 64% were male, 12 patients (43%) were on oral anticoagulants prior to injury, and mean injury severity score was 8.3 ± 7.0. Five patients (18%) had LeFort fractures (1 with LeFort I, 4 with LeFort II), and 5 (18%) had isolated mandible fractures (2 were bilateral). Nearly half of all patients suffered neurological injury (concussion: 18%, intracranial hemorrhage: 29%). Average hospital length of stay (LOS) was 4.0 ± 2.9 days. Eight patients (29%) required intensive care unit (ICU) admission with an average ICU-LOS of 2.8 ± 1.2 days. Surgical management was required in 4 patients (14%). More than half of the patients returned home (54%), 25% were discharged to a skilled nursing facility, 4% to rehabilitation, 7% to hospice, and 7% expired. Nearly one-third of patients required discharge to a higher level of care facility than their location prior to injury. GLF-induced FFs are often associated with significant injuries and serve as an indicator of functional decline. These injuries warrant trauma center admission for comprehensive evaluation and management.

Keywords: facial fractures; geriatric; ground-level falls.