Prospective Bicentric Study on Characteristics and Management of Elderly Patients Presenting to the Emergency Department With Cranio-Maxillofacial Trauma

INTRODUCTION: As the global population ages, maxillofacial trauma incidence in the elderly is increasing and may contribute substantially to emergency department (ED) workload. This prospective bicentric study aims to analyse characteristics and management of patients aged over 60 years presenting to the ED with maxillofacial fractures in 2 third-level trauma centres. MATERIALS AND METHODS: The following data were collected: age, sex, clinical comorbidities, Charlson Comorbidity Index (CCI), anticoagulant/antiplatelet therapy, dentition status, cause of trauma, site and type of fracture, Facial Injury Severity Scale (FISS), and associated injuries. Post-traumatic functional symptoms were assessed at initial ED presentation and reassessed at 6 weeks and 3 months. RESULTS: From 01.01.2024 to 31.12.2024, 396 non-hospitalized and 52 hospitalized patients were included. Statistical analysis showed that hospitalised patients were significantly younger [median age: 69 y, IQR (interquartile range) 13 versus 79 y, IQR: 14] ( p < 0.001); were less frequently on anticoagulant/antiplatelet therapy ( p = 0.001); showed lower CCI ( p = 0.026); presented with more functional symptoms ( p < 0.001); had more displaced and multiple fractures ( p < 0.001); and exhibited higher FISS values ( p < 0.001). DISCUSSION: In this large prospective cohort, most elderly with maxillofacial fractures were managed non-operatively. Surgical treatment was primarily reserved for younger, less comorbid patients with complex or displaced fractures and significant functional symptoms. These findings contribute to a more accurate understanding of ED workload and may support health care planning for an ageing population.