Factors associated with prolonged hospital stay in mandibular condylar fractures: a multicenter retrospective study in Indonesia

Mandibular condylar fractures constitute a significant proportion of maxillofacial trauma and are associated with functional impairment and increased healthcare utilization. However, factors associated with the duration of hospital stay remain insufficiently understood, particularly in low- and middle-income countries (LMICs). This study aimed to characterize the epidemiology of mandibular condylar fractures and identify factors associated with prolonged hospital stay. A retrospective multicenter study was conducted across three tertiary referral centers in Indonesia from January 2020 to May 2025. A total of 178 patients with confirmed mandibular condylar fractures were included. Variables analyzed included demographic characteristics, mechanism of injury, fracture characteristics, presence of associated mandibular fractures, and treatment modalities. Length of hospital stay (LoS) was analyzed as a dichotomous outcome (< 7 vs. ≥ 7 days), with the 7-day threshold selected based on the cohort median and clinical interpretability. Bivariate analyses were followed by multivariable logistic regression. Sensitivity analysis was performed using negative binomial regression with continuous LoS. Road traffic accidents (80.9%) were the predominant mechanism of injury, and 72.5% of patients presented with multiple mandibular fractures. In multivariable analysis, road traffic accidents (OR = 2.715; 95% CI = 1.131–6.515; p = 0.025) and the presence of multiple mandibular fractures (OR = 3.464; 95% CI = 1.710–7.016; p < 0.001) were significantly associated with prolonged hospital stay. In contrast, age, gender, and treatment modality were not significantly associated with LoS. Condylar fracture patients involved in road traffic accidents or those presenting with multiple mandibular fractures were more likely to experience prolonged hospital stay. These findings suggest that injury-related characteristics may be more closely associated with hospitalization outcomes than fracture-specific characteristics within this cohort. However, the observed associations should be interpreted cautiously given the retrospective design, the absence of standardized trauma severity measures, and substantial missing data for several groups. Early identification of patients presenting with these characteristics may support risk stratification and optimize resource allocation in resource-limited settings.