{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:32:37Z","timestamp":1787841157309,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n Surgical management of odontoid fractures in the cervical spine is utilized to promote higher fusion rates, reduce medical complications, and limit mortality. Delay in surgical management of operative odontoid fractures after hospital admission, however, may be associated with greater rates of adverse events and length of stay. We sought to evaluate the effect of surgical delay on unplanned reoperation and increased length of stay following anterior fixation of odontoid fractures.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n A retrospective observational study was conducted on patients who underwent anterior fixation for an odontoid fracture from 2013 to 2022, utilizing the National Surgical Quality Improvement Program database. Eligibility for inclusion was age >18 years and current procedural terminology codes 22,318 and 22,319. Outcomes, including length of stay, mortality, and reoperation, were compared between cohorts. Prolonged time between hospital admission and surgery \u226548 h was assessed as a predictor of clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 265 patients, 85 (32.1%) had a surgical delay. Age, sex, race, body mass index, and other medical comorbidities were statistically similar at baseline between groups. Surgical delay was associated with greater length of stay (8.2 vs. 4.5 days,\n P<\/jats:italic>\n = 0.012) and unplanned reoperation (11.8% vs. 3.3%,\n P<\/jats:italic>\n = 0.011), and trended toward association with readmission (9.4% vs. 3.3%,\n P<\/jats:italic>\n = 0.072). Multivariate Poisson regression demonstrated that surgical delay independently predicted length of stay (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n = 257.75,\n P<\/jats:italic>\n < 0.001) and unplanned reoperation (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n = 5.24,\n P<\/jats:italic>\n < 0.001), but not readmission (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n = 3.21,\n P<\/jats:italic>\n = 0.073).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Surgical delay was an independent and significant predictor of increased length of stay and reoperation. These results suggest that surgery should be performed promptly within 48 h when indicated to minimize the risk of adverse outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_141_25","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T12:01:45Z","timestamp":1758196905000},"page":"307-311","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of surgical delay on 30-day reoperation rates and length of stay after anterior fixation of odontoid fractures"],"prefix":"10.4103","volume":"16","author":[{"given":"Ryan","family":"Hoang","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, The University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyue","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, The University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirooz","family":"Fereydouni","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, The University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Cowman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, The University of California, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junho","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Essig","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, North Shore University Hospital-Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra University, New Hyde Park, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohrab","family":"Virk","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, North Shore University Hospital-Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra University, New Hyde Park, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austen","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, North Shore University Hospital-Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra University, New Hyde Park, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"R2-20250926","doi-asserted-by":"crossref","first-page":"6270","DOI":"10.3390\/jcm13206270","article-title":"Odontoid fractures:A review of the current state of the art","volume":"13","author":"Nouri","year":"2024","journal-title":"J Clin Med"},{"key":"R3-20250926","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1227\/neu.0000000000002557","article-title":"Surgery decreases nonunion, myelopathy, and mortality for patients with traumatic odontoid fractures:A propensity score matched analysis","volume":"93","author":"Cloney","year":"2023","journal-title":"Neurosurgery"},{"key":"R4-20250926","doi-asserted-by":"crossref","first-page":"12S","DOI":"10.1177\/2192568218768227","article-title":"Spine Section of the German Society for Orthopaedics and Trauma. Treatment of odontoid fractures:Recommendations of the spine section of the german society for orthopaedics and trauma (DGOU)","volume":"8","author":"Gonschorek","year":"2018","journal-title":"Global Spine J"},{"key":"R5-20250926","doi-asserted-by":"crossref","first-page":"475","DOI":"10.21037\/jss.2019.10.09","article-title":"Risk factors for delay in surgery for patients undergoing elective anterior cervical discectomy and fusion","volume":"5","author":"Renfree","year":"2019","journal-title":"J Spine Surg"},{"key":"R6-20250926","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1177\/2192568217698132","article-title":"Short-term complications of anterior fixation of odontoid fractures","volume":"8","author":"Cutler","year":"2018","journal-title":"Global Spine J"},{"key":"R7-20250926","doi-asserted-by":"crossref","first-page":"603","DOI":"10.14245\/ns.2040362.181","article-title":"Outcomes of patients undergoing anterior screw fixation for odontoid fracture and analysis of the predictive factors for surgical failure","volume":"17","author":"Lee","year":"2020","journal-title":"Neurospine"},{"key":"R8-20250926","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/j.spinee.2024.01.019","article-title":"Postoperative racial disparities following spine surgery are less pronounced in the outpatient setting","volume":"24","author":"Amen","year":"2024","journal-title":"Spine J"},{"key":"R9-20250926","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1007\/s11999-014-3597-7","article-title":"Use of the national surgical quality improvement program in orthopaedic surgery","volume":"473","author":"Molina","year":"2015","journal-title":"Clin Orthop Relat Res"},{"key":"R10-20250926","doi-asserted-by":"crossref","first-page":"673","DOI":"10.5435\/JAAOS-D-15-00217","article-title":"Nationwide databases in orthopaedic surgery research","volume":"24","author":"Bohl","year":"2016","journal-title":"J Am Acad Orthop 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room","volume":"39","author":"Meyers","year":"2024","journal-title":"J Perianesth Nurs"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_141_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:43:17Z","timestamp":1787838197000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_141_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_141_25","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-07-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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