Association between maxillofacial fractures and brain injuries in trauma patients: a cross-sectional study in the Kingdom of Saudi Arabia

Al-Ghamdi, Sameer; Alasmari, Fahad Shaddad; Alarjani, Mohammed Bader; Alamri, Hassan Sultan; Aldamkh, Abdullah Ali; Alanazi, Ibrahim Abdullah; Alarjani, Musab Bader; Moafa, Abdulrhman Ibrahim; Alrusayyis, Nawaf Saad

doi:10.11604/pamj.2022.43.193.36283

Cited by 4 publications

(7 citation statements)

References 24 publications

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“…Our finding of higher CVD risk associated with LTBI is consistent with findings in high-TB-incidence settings [ 25 – 28 ] but expands to high-income and low-TB-incidence settings. While the exact mechanism relating LTBI to CVD has not been fully elucidated, studies indicate that LTBI increases inflammation and pro-inflammatory cytokines, which may cause direct vascular damage as well as immune activation associated with LTBI [ 34 , 35 ].…”

Section: Discussionsupporting

confidence: 89%

“…The present study has several strengths. First, we used a large population-based longitudinal cohort that overcomes the small sample size issue in previous studies [ 25 – 28 ]. Second, our study overcomes the temporal limitations of previous cross-sectional studies [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…First, we used a large population-based longitudinal cohort that overcomes the small sample size issue in previous studies [ 25 – 28 ]. Second, our study overcomes the temporal limitations of previous cross-sectional studies [ 27 , 28 ]. Third, we used provincial TB registry data to ascertain the LTBI exposure status and linked health administrative databases with near-complete capture of hospital encounters, physician visits, and death data to ascertain the CVD outcome status.…”

Section: Discussionmentioning

confidence: 99%

“…We identified potential confounders based on the literature and a causal diagram (see Supplementary Figure 1 on ). The following covariates were identified as potential confounders: age at immigration, sex, income, education, World Health Organization (WHO) region of birth, immigration class, smoking, alcohol use disorder, substance use disorder, hypertension, diabetes, chronic kidney disease, obesity, HIV/AIDS, and dyslipidemia [ 3 , 4 , 25 – 28 ]. The definition of these covariates is shown on and of the Supplementary Material.…”

Section: Methodsmentioning

confidence: 99%

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Role of latent tuberculosis infection on elevated risk of cardiovascular disease: a population-based cohort study of immigrants in British Columbia, Canada, 1985–2019

Hossain¹,

Johnston²,

Cook³

et al. 2023

Epidemiol. Infect.

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We investigated the risk of cardiovascular disease (CVD) associated with latent tuberculosis infection (LTBI) (Aim 1) and LTBI therapy (Aim 2) in British Columbia, where tuberculosis (TB) incidence is low, and 86% of people with TB are born outside of Canada. Using linked immigration, public health surveillance, and health administrative databases, we developed a population-based retrospective cohort of immigrants between 1985 and 2019. A total of 49,197 participants had valid LTBI test results. Cox proportional hazards model was fitted, adjusting for potential confounders. Compared to the participants who tested LTBI negative, LTBI positive was associated with an 8% higher CVD risk in complete case data (adjusted hazard ratio [HR]: 1.08, 95% CI: 0.99-1.18), a statistically significant 11% higher risk when missing confounder values were imputed using multiple imputation (HR: 1.11, 95% CI: 1.02-1.20), and 10% higher risk when additional proxy variables supplementing known unmeasured confounders were incorporated in the high-dimensional disease risk score technique to reduce residual confounding (HR: 1.10, 95% CI: 1.01-1.20). Also, compared to participants who tested negative, CVD risk was 27% higher among people who were LTBI positive but did not complete LTBI therapy (HR: 1.27, 95% CI: 1.04-1.55), while the risk was similar in people who completed LTBI therapy (HR: 1.04, 95% CI: 0.87-1.24). Findings were consistent in different sensitivity analyses. We concluded that LTBI is associated with an increased CVD risk in a low-tuberculosis-incidence setting, with a higher risk associated with incomplete LTBI therapy and attenuated risk when therapy is completed.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Role of latent tuberculosis infection on elevated risk of cardiovascular disease: a population-based cohort study of immigrants in British Columbia, Canada, 1985–2019

Hossain¹,

Johnston²,

Cook³

et al. 2023

Epidemiol. Infect.

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“…Traumatic injuries cause 5.8 million deaths each year, which is 10% of all deaths around the world [1]. Such injuries affect various parts of the body, with a high association of morbidity and mortality found in brain and maxillofacial injuries, which affect the quality of life of injured individuals [2].…”

Section: Introductionmentioning

confidence: 99%

Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study

Alassaf,

Khan,

Habib

et al. 2023

Cureus

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Background: When dealing with traumatized patients, it is crucial to prioritize securing their airway. However, intubating someone who has sustained significant facial injuries can pose difficulties, as the narrow and altered shape of their upper airway may impede their ability to open their mouth. In light of this, the purpose of this study is to evaluate the volumetric and morphological alterations to the upper airway resulting from facial trauma by utilizing computed tomography (CT) scans.Method: This is a single-centered retrospective analytical study. This study included CT scans of patients with traumatic facial injuries admitted to King Fahad Hospital in Madinah, Saudi Arabia. Study variables included age, gender, body mass index (BMI), fractured bones, airway symmetry, and airway volume. Using the 3D Slicer software (Slicer Community, USA), a three-dimensional model of the pharyngeal airway was constructed from the CT scan to evaluate symmetry and volume. IBM SPSS Statistics for Windows, version 23 (released 2013; IBM Corp., Armonk, New York, United States) was used to analyze data.Results: Among the screened scans, 136 cases with traumatic facial injuries were included in the study. Age ranged from four to 91 years, with a mean of 28.26 (±14.9). Mandibular and zygomatic fractures were the most common, with 71 (52.2%) and 69 (50.7%) cases, respectively. The pharyngeal airway was symmetric in 111 (81.6%) cases and not symmetric in the other 25 (18.4%) cases. A significant association was found between the side of the fracture and airway asymmetry in mandibular fractures (p-value = 0.03). The total airway volume in the displaced mandibular fractures showed a statistically significant decrease (p-value = 0.019). The fracture sites were not statistically linked to airway asymmetry except for parasymphyseal and symphyseal fractures, with a p-value of 0.038 and 0.041, respectively. Conclusion:The study findings suggest that the pharyngeal airway is not usually compromised in most facial bone fractures; however, bilateral displaced mandibular fractures have the potential to diminish the pharyngeal airway volume, especially in fractures involving the symphysis and parasymphysis area.

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Factors influencing traumatic brain injuries in maxillofacial fractures: A 12‐year retrospective analysis of 2841 patients

Mao,

Xue,

et al. 2024

Dental Traumatology

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Background/AimResults of studies investigating the association between traumatic brain injury (TBI) and maxillofacial fractures (MFs) have varied considerably. The present study aimed to evaluate the correlation between TBIs and MFs, as well as the impact of age, sex, trauma mechanism, and season on TBIs.Materials and MethodsThis 12‐year retrospective study of 2841 patients used univariate and multivariate logistic regression to assess the association between MFs and other factors impacting TBIs.ResultsAmong 2841 patients, 1978 TBIs occurred in 829 (29.2%), with intracranial injuries (n = 828) is the most common. Of 829 patients with TBIs, 688 were male and 141 were female, corresponding to a male‐to‐female ratio of 4.9:1.0. The most common age group was 40–49 years (24.6%). Vehicles (including motor vehicles and electric vehicles) accidents were the primary causes of injuries. Multivariate regression analyses revealed an increased risk for TBIs among males (odds ratio [OR] 0.632, p < 0.001). Patients >40 years of age were at higher risk for TBIs, especially those ≥70 years (OR 3.966, p = 0.001). Vehicle accidents were a high‐risk factor for TBIs (OR 6.894, p < 0.001), and winter was the most prevalent season for such injuries (OR 1.559, p = 0.002). Risk for TBI increased by 136.4% in combined midfacial and mandibular fractures (p = 0.016) and by 101.6% in multiple midfacial fractures (p = 0.045). TBIs were less common in single mandibular fractures, notably in single‐angle fractures, with a risk of only 0.204‐fold.ConclusionTBIs in MFs were significantly correlated with sex, age, aetiology, season and fracture location. Maxillofacial surgeons and emergency physicians must be aware of the possible association between TBIs and MFs to assess and manage this complicated relationship in a timely manner.

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Association between maxillofacial fractures and brain injuries in trauma patients: a cross-sectional study in the Kingdom of Saudi Arabia

Cited by 4 publications

References 24 publications

Role of latent tuberculosis infection on elevated risk of cardiovascular disease: a population-based cohort study of immigrants in British Columbia, Canada, 1985–2019

Role of latent tuberculosis infection on elevated risk of cardiovascular disease: a population-based cohort study of immigrants in British Columbia, Canada, 1985–2019

Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study

Factors influencing traumatic brain injuries in maxillofacial fractures: A 12‐year retrospective analysis of 2841 patients

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