Facial fractures and associated injuries in high- versus low-energy trauma: all are not created equal

Hilaire, Cameron St.; Johnson, Arianne; Loseth, Caitlin; Alipour, Hamid; Faunce, Nick; Kaminski, Stephen; Sharma, Rohit

doi:10.1186/s40902-020-00264-5

Cited by 13 publications

(19 citation statements)

References 10 publications

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“…The median length of hospital stay in our study was three days compared with 7.5 days of Mijiti et al [24]. Those with pan facial fractures and cranial injuries stay longer in the hospital [2][3][4][5]. The overall mortality in our study was 2.7% which is similar to others [5,23].…”

Section: Discussionsupporting

confidence: 82%

“…The most commonly injured body regions associated with the face injury were the head (49.4.4%), followed by the chest (39.7%). The median (range) ISS was 5 (5-75), and the median (range) GCS was 15 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Patients stayed for a median (range) of 3 (1-95) days in the hospital.…”

Section: Resultsmentioning

confidence: 99%

“…One third of the severely injured patients have facial injuries [1]. These injuries have devastating long-term negative impact on quality of life and may need multiple constructive and plastic surgery with lengthy hospital stay [2,3,4]. They are usually associated with life-threatening serious injuries of the head and chest [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…They are usually associated with life-threatening serious injuries of the head and chest [5,6]. Their mechanism of injury include road tra c collisions (RTCs), assaults, sports injuries, falls, industrial injuries [2][3][4], and animal-related injuries [7]. The epidemiology of facial injuries varies worldwide including the prevalence, cause, injury pattern, severity, and clinical outcome depending on the socio-economic status and culture of the population [8].…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates

Al-Ali

Alao

Abu‐Zidan

2022

Preprint

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Background: Facial injuries affect one third of severely injured patients. These injuries have devastating long-term negative impact on quality of life. We aimed to study the epidemiology of facial injuries and factors affecting mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates Methods: This is a retrospective analysis of a prospectively collected data from Al-Ain Hospital Trauma Registry. All patients with facial injury who were hospitalized for more than 24 hours or who died after arrival at the hospital during the period from January 2014 to December 2017 were studied. Univariate analysis was used to compare patients who died and those who survived. Significant factors were then entered into a backward logistic regression model to define factors affecting mortality. Results: 408 patients having a mean age of 31.9 years were studied, 87.3% were males. The main mechanisms of injury were road traffic collisions (45.1%) and fall from height (11.3%). 289 (70.8%) patients had associated injuries which were mainly in the head and chest. The backward logistic regression model showed that GCS was the only factor that predicted mortality, p<0.0001 with the best cut-off point of 7.5 having a sensitivity of 0.972 and a specificity of 0.8. The ROC had an area under the curve of 0.924.Conclusions: Majority of facial injury patients in our setting are young males who were involved in road traffic collsions or falls from height. The most important factor prediciting mortality of these patients was the low GCS. Those having GCS of 8 and more had a better chance for survival. This information is very important when counselling patients or their relatives for facial surgery.

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Section: Discussionsupporting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors affecting mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates

Al-Ali

Alao

Abu‐Zidan

2022

Preprint

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“…Their study differed from ours in that ground-level falls only occurred in just 14% of their cohort compared to over 40% in our study. 21 In a review of 980 patients with facial fractures in Australia, Cabalag et al reported their experience on fracture patterns and management. 5 Similar to our study, they found that approximately half of patients were treated without surgery.…”

Section: Management Trendsmentioning

confidence: 99%

Patterns of Facial Fractures in a Major Metropolitan Level 1 Trauma Center: A 10‐year Experience

et al. 2021

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Objective/Hypothesis: To report characteristics and management of facial fractures in a major metropolitan center within the United States.Study Design: Retrospective chart review. Methods: Retrospective review at a level 1 trauma academic medical center of 3,946 facial fractures in 1,914 patients who presented from 2008 to 2017. Demographics, injury mechanism, associated injuries, and treatment information were collected. Logistic regression analyses were performed to determine factors associated with management.Results: There were 1,280 males and 630 females with a median age of 42 years. Orbital fractures were the most common (41.4%) followed by maxilla fractures (21.9%). The most common mechanism was fall (43.6%). Surgical management was recommended for 38% of patients. The odds of surgical management were less for females (OR 0.59, 95% CI 0.48-0.73). Patients over 70 years were significantly less likely to undergo surgery compared to other age groups (OR 0.15-0.36, P < .001). The odds of surgical management were 1.69 times greater for patients with more than three fractures than for a single fracture (95% CI 1.18-2.42) and 2.23 times greater for traffic injuries compared to injuries from activities of daily living (95% CI 1.42-3.5).Conclusions: This represents one of the largest comprehensive databases of facial fractures. Our patients were most frequently injured during activities of daily living, most commonly from falls. The majority of patients were managed conservatively. Gender, age, fracture number, and mechanism of injury were independently associated with the decision to treat surgically. Our data are in stark contrast to that from other populations in which assault or motor vehicle accidents predominate.

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Trends in Management and Cost Burden of Facial Fractures: A 14‐Year Analysis

Weitzman,

Subramanian,

Zhao

et al. 2024

The Laryngoscope

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ObjectiveTo discuss patient demographics and management and better understand the economic impact associated with the treatment of facial fractures at a major metropolitan level 1 trauma center.Study DesignRetrospective chart review.MethodsWe identified 5088 facial fractures in 2479 patients who presented from 2008 to 2022. Patient demographics, mechanism of injury, associated injuries, treatment information, and hospital charges were collected and analyzed to determine factors associated with surgical management and increased cost burden.ResultsOur 14‐year experience identified 1628 males and 851 females with a mean age of 45.7 years. Orbital fractures were most common (41.2%), followed by maxilla fractures (20.8%). The most common mechanism was fall (43.0%). Surgical management was recommended for 41% of patients. The odds of surgical management was significantly lower in female patients, patients age 65 and older, and patients who presented after the onset of the COVID‐19 pandemic. The odds of surgical management was significantly higher for patients who had a mandible fracture or greater than 1 fracture. The average cost of management was highest for naso‐orbito‐ethmoidal fractures ($37,997.74 ± 52,850.88), followed by LeFort and frontal fractures ($29.814.41 ± 42,155.73 and $27,613.44 ± 39.178.53, respectively). The highest contributor to the total average cost of management was intensive care unit‐related costs for every fracture type, except for mandible fractures for which the highest contributor was operating room (OR)‐related costs.ConclusionsThis study represents one of the largest comprehensive databases of facial fractures and one of the first to provide a descriptive cost analysis of facial trauma management.Level of Evidence4 Laryngoscope, 2024

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Facial fractures and associated injuries in high- versus low-energy trauma: all are not created equal

Cited by 13 publications

References 10 publications

Factors affecting mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates

Factors affecting mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates

Patterns of Facial Fractures in a Major Metropolitan Level 1 Trauma Center: A 10‐year Experience

Trends in Management and Cost Burden of Facial Fractures: A 14‐Year Analysis

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