# Systemic Outcomes in Adults Undergoing Emergent Repair of Orbital Blowout Fractures

## TL;DR

This study finds that emergency surgery for orbital fractures is linked to longer hospital stays but not more systemic complications.

## Contribution

The study identifies emergent surgery status as an independent risk factor for prolonged hospitalization in orbital fracture repairs.

## Key findings

- Emergent surgery is associated with a higher risk of prolonged length of stay (OR 13.05).
- Emergent repairs had higher rates of preoperative wound infection and systemic sepsis.
- Emergent status was not linked to increased systemic complications overall.

## Abstract

To analyze the association between emergent surgery status and systemic adverse outcomes in patients undergoing open orbital floor blowout fracture repair.

This retrospective cohort analysis utilized the 2005–2018 National Surgery Quality Improvement Program (NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify cases with open treatment of orbital floor blowout fractures (21385, 21386, 21387, 21390, 21395). Demographics, comorbidities, and complication incidences were compared between patients undergoing emergent surgery and those undergoing non-emergent orbital blowout fracture repair using chi-square analyses. The independent effect of preoperative emergent status on adverse outcomes was analyzed using binary logistic regression.

1,146 (96.0%) non-emergent and 48 (4.0%) emergent orbital blowout fracture repairs were identified from 2005 to 2018. Chi-square analysis indicated patients undergoing emergent repairs had higher incidences of preoperative wound infection (8.3% vs. 2.3%; p = 0.029) and systemic sepsis (8.3% vs. 0.6%; p = 0.001). The emergent cohort had a higher proportion of patients with Hispanic ethnicity (p = 0.011). Unadjusted chi-square analysis indicated the emergent cohort had a higher incidence of prolonged length of stay (50.1% vs. 10.1%; p < 0.001). After adjusting for confounders, logistic regression analysis indicated emergent status was an independent risk factor for prolonged length of stay (OR 13.05; 95% CI 5.26–32.37; p < 0.001).

Emergent surgery status is an important factor associated with increased odds of prolonged length of stay in patients undergoing open orbital blowout fracture repair.

The online version contains supplementary material available at 10.1007/s12070-024-04681-0.

This national database analysis evaluated over 1000 orbital blowout fractures cases and ascertained that emergent status of orbital blowout fracture repair outcomes is generally not associated with systemic complications in adults.

The online version contains supplementary material available at 10.1007/s12070-024-04681-0.