{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T01:02:27Z","timestamp":1793062947985,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,1,22]],"date-time":"2023-01-22T00:00:00Z","timestamp":1674345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess how traditional, simple markers of health independently affect postoperative morbidity of mandibular fracture open reduction\u2010internal fixations (ORIFs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National Surgical Quality Improvement Project (NSQIP) Database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The 2005 to 2017 NSQIP database was queried for patients who underwent mandibular ORIF. To control for the severity of the trauma, an additional \u201cconcurrent surgery\u201d variable was created. A modified 5\u2010item frailty index was calculated based on the following: presurgery\u2010dependent\u00a0functional status, chronic hypertension, diabetes mellitus, history of chronic obstructive pulmonary disease, and history of congestive heart failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1806 patients with mandibular ORIFs (mean age 34.8\u2009\u00b1\u200915.4 years), modified frailty index (mFI) was associated with 30\u2010day medical complications (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), reoperation (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and readmission (<jats:italic>p<\/jats:italic>\u2009=\u2009.005) on univariate analysis. Increased age was associated with prolonged hospitalization (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and medical complications (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The increased American Society of Anesthesiologists (ASA) score was associated with all endpoints (<jats:italic>p<\/jats:italic>\u2009\u2264\u2009.003), while increased body mass index (BMI) was associated with none. On multivariate analysis, only increased ASA was associated with any adverse event (reference: ASA 1; ASA 2,\u00a0odds ratio [OR]: 2.17 [95% confidence interval, CI: 2.17\u20103.71], <jats:italic>p<\/jats:italic>\u2009=\u2009.004; ASA 3\u20104, OR: 3.63 [95% CI: 1.91\u20106.91], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Similarly, mFI and BMI were not independently associated with prolonged hospitalization (\u22652 days) (<jats:italic>p<\/jats:italic>\u2009\u2265\u2009.015), but 65+ age (reference: 18\u201049; OR: 2.33 [95% CI: 1.40\u20103.86], <jats:italic>p<\/jats:italic>\u2009=\u2009.001) and ASA 3 to 4 groups (reference: ASA 1; OR: 3.26 [95% CI: 2.06\u20105.14], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) were.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ASA status and age are more useful modalities than mFI or BMI in predicting poor postoperative morbidity in mandibular ORIF. These simple metrics can assist with managing surgeons' expectations for mandibular ORIF patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.181","type":"journal-article","created":{"date-parts":[[2023,1,22]],"date-time":"2023-01-22T16:48:27Z","timestamp":1674406107000},"page":"1006-1014","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Frailty, Age, ASA Classification, and BMI on Postoperative Morbidity in Mandibular Fracture ORIF"],"prefix":"10.1002","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3416-5976","authenticated-orcid":false,"given":"Theodore V.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina J.","family":"Torabi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khodayar","family":"Goshtasbi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley R.","family":"Lonergan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parsa P.","family":"Salehi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yarah M.","family":"Haidar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tjoson","family":"Tjoa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Kuan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28690"},{"key":"e_1_2_8_3_1","first-page":"1","volume-title":"StatPearls","author":"Yuen H\u2010W","year":"2021"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001273"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2003.50118"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2011.05.015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000157328.10583.A7"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(00)90051-X"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(03)00147-2"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.04.079"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12049"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/2000656X.2019.1688166"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004990"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2004.02.007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30455"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28307"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2009.09.031"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.3969"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22829"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.11.005"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26588"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820955180"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28373"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211010443"},{"issue":"5","key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1097\/SCS.0000000000006425","article-title":"An epidemiological analysis and comparison of single site and multiple site fracture repair","volume":"31","author":"Torabi SJ","year":"2020","journal-title":"J\u00a0Craniofac\u00a0Surg"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-55459-2"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1655756"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.04.056"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.07.087"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.05.029"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.03.052"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.01.021"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2021.09.026"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27494"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.138"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.7.605"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.107454"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(98)70268-2"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12126"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1577"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2004.03.001"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1080\/03610730802545051"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-016-0329-8"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-020-05422-4"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.1.27"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1603460"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000216508.95556.cc"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.4304"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24189"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2014.06.021"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2008.06.058"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2015.01.009"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.181","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.181","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:23:14Z","timestamp":1760966594000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,22]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1002\/ohn.181"],"URL":"https:\/\/doi.org\/10.1002\/ohn.181","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,22]]},"assertion":[{"value":"2022-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}