{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T21:08:56Z","timestamp":1769116136186,"version":"3.49.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To determine significant associations between patient frailty status and odontoid fractures across common traumatic mechanisms of injuries (MOIs) in the elderly.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective review.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Single, academic-affiliated hospital with full surgical services.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>Patients 65 years or older with traumatic odontoid fractures were included.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Nonoperative management (soft\/hard collar, halo, traction tongs, and Minerva) and\/or operative fixation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Modified frailty index (mFI), MOI, concurrent injuries, inpatient length of stay (LOS), reoperation, and mortality rates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Seventy patients were included (80.6 \u00b1 8.5 years, 60% F, 88% European, 10% Maori\/Pacific, 1.4% Asian, Charlson Comorbidity Index 5.3 \u00b1 2.2, mFI 0.21 \u00b1 0.15). The most common MOIs were falls (74.3%), high-speed motor vehicle accidents (MVAs) (17.1%), low-speed MVAs (5.7%), and pedestrian versus car (2.9%). Patients with traumatic falls exhibited significantly higher mFI scores (0.25) compared with low-speed MVAs (0.16), high-speed MVAs (0.08), and pedestrian versus car (0.01) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.003). Twenty-seven patients with odontoid fractures were frail, 33 were prefrail, and 10 were robust. Ninety-two percent of frail patients had a traumatic fall as their MOI, as opposed to 73% of prefrail and 30% of robust patients (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Prefrail and frail patients were 4.3 times more likely than robust patients to present with odontoid fractures through traumatic fall [odds ratio (OR): 4.33 (1.47\u201312.75), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.008], and frailty increased likelihood of reoperation [OR: 4.2 (1.2\u201314.75), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.025] and extended LOS [OR: 5.71 (1.05\u201310.37), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.017]. Frail patients had the highest 30-day (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.017) and 1-year mortality (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) compared with other groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Patients with traumatic odontoid fractures from falls were significantly more frail in comparison with any other MOIs, with worse short- and long-term outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001597","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T18:13:37Z","timestamp":1564510417000},"page":"e484-e488","source":"Crossref","is-referenced-by-count":13,"title":["Association Between Frailty Status and Odontoid Fractures After Traumatic Falls: Investigation of Varying Injury Mechanisms Among 70 Elderly Odontoid Fracture Patients"],"prefix":"10.1097","volume":"33","author":[{"given":"Haddy","family":"Alas","sequence":"first","affiliation":[{"name":"Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank A.","family":"Segreto","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoi Ying","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Waikato Hospital, Hamilton, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avery E.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine E.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cole A.","family":"Bortz","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha R.","family":"Horn","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher G.","family":"Varlotta","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Departments of Orthopaedic and Neurological Surgery, NYU Langone Medical Center, NY Spine Institute, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Waikato Hospital, 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