Li K, et al. - Researchers evaluated the factors that confer risk for septorhinoplasty following the initial treatment of isolated nasal fracture. Risk factors for surgical revision of initial treatment of nasal fracture included a preexisting diagnosis of nasal obstruction or defect and other aspects of a patient’s history.

Methods

•  Researchers performed a retrospective population-based analysis of US patients diagnosed with nasal fracture between January 1, 2007, and December 31, 2015.
• They used insurance claims data from the Commercial and Medicare Supplemental categories of the Truven Health MarketScan database.
• Final study cohort included 78,474 of 340,715 patients diagnosed with nasal fracture, excluding those who did not meet enrollment criteria or were diagnosed with concomitant facial fracture.
• Based on the type and timing of treatment, patients were classified into 1 of 4 groups.
• Main outcomes and measures included septorhinoplasty between 6 and 24 months after nasal fracture diagnosis, and initial fracture treatment, demographics, comorbidities, and diagnoses associated with a preexisting nasal obstruction or defect as explanatory variables.

Results

• The characteristics of the cohort were: most of the 78,474 patients were under 65 years of age (66,770 [85.1%]) and male (41,997 [53.5%]) and lived in an urban area (67,938 [86.6%]).
• Increased risk of subsequent septorhinoplasty was observed in relation to open treatment within 3 weeks (adjusted odds ratio [aOR], 1.76; 95% CI, 1.33-2.32) of nasal fracture and between 3 weeks and 6 months (aOR, 1.52; 95% CI, 1.14-2.04) after fracture among patients with no preexisting diagnosis of nasal obstruction or defect.
• Increased risk of subsequent septorhinoplasty was reported in patients with a diagnosis of preexisting nasal obstruction or defect in relation to all of the following: observation (aOR, 3.56; 95% CI, 2.80-4.53), closed reduction treatment (aOR, 3.10; 95% CI, 1.93-4.96), and open treatment within 3 weeks (aOR, 2.02; 95% CI, 1.48-2.77) of fracture, with observation having the highest risk.
• Subsequent septorhinoplasty was more likely if patients were younger than 65 years, with the greatest risk seen in patients 18 to 34 years of age (aOR, 6.02; 95% CI, 4.26-8.50), lived in an urban area (aOR, 1.21; 95% CI, 1.01-1.44), or had a history of anxiety (aOR, 1.45; 95% CI, 1.18-1.78), but being male less likely predispose to subsequent septorhinoplasty (aOR, 0.82; 95% CI, 0.73-0.91).