National Analysis of Risk Factors for Nasal Fractures and Associated Injuries in Trauma

Abstract

Nasal fractures account for up to 58% of facial fractures. However, the literature characterizing associated injuries and risk factors for nasal fractures is sparse and is mostly composed of single-center experiences. This study sought to provide a large descriptive analysis and identify associated injuries and risk factors for nasal fractures in trauma using a national database. A retrospective analysis of the National Trauma Data Bank (NTDB) from 2007 to 2015 was performed. Patients ≥18 years of age with nasal fractures were included. A multivariable logistic regression model was used to identify predictors for nasal fracture in trauma. Of 5,494,609 trauma patients in the NTDB, 255,533 (4.6%) had a nasal fracture. Most were male (74.8%) with a mean age of 45.6 years. Blunt trauma accounted for 90.5% of fractures, with motor vehicle accident being the most common mechanism (27.5%). Closed fractures occurred in 93.0% of patients. Concomitant injuries included traumatic brain injury (TBI; 56.9%), malar/maxillary fracture (27.9%), and open wound of the face (38.6%) and nose (9.5%). Of all patients, 10.1% underwent closed or open reductions at index hospitalization. The strongest associated injuries with nasal fracture included open wound of the nose (odds ratio [OR]: 8.71, 95% confidence interval [CI]: 8.49–8.94, p < 0.001), epistaxis (OR: 5.26, 95% CI: 4.59–6.02, p < 0.001), malar/maxillary fracture (OR: 4.38, 95% CI: 4.30–4.45, p < 0.001), and orbital fracture (OR: 3.99, 95% CI: 3.91–4.06, p < 0.001). Nasal fractures are common traumatic injuries with more than 90% occurring by blunt mechanism and over half suffering from a concomitant TBI. The strongest associated injury with nasal fracture is an open wound of the nose.

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

“…Over half of our LEM patients tested positive for ethanol in contrast to only 22% of our HEM patients. Prior studies have recognized ethanol use as a common feature of patients at the time of facial trauma, but the higher prevalence in patients with FFs after LEMs compared to HEMs has not been reported [11,12]. Given the two most common MOIs for the LEM group were assaults and groundlevel falls, our findings further implicate ethanol use as an important factor in these MOIs, and may offer an opportunity for targeted injury-prevention strategies.…”

Analysis of Nasal Bone Fractures: Etiological and Demographic Characteristics

“…The causes of the nasal fractures in this study are shown in Fig. (2). Road Traffic accidents (RTA) were the main cause in 53.8%, whereas the second most frequent cause of fracture was assault from others, reported by 24.7% of the patients.…”

“…Being the most prominent central part of the face, the nose is commonly exposed to trauma. Fractures of the nose are the commonest facial fractures forming almost 58% of the fractures of the facial skeleton [1,2]. Causes of nasal bone fractures (NBFs) are variable and differ according to socioeconomic status, geographic areas, cultural and other factors [3].…”

Facial Fractures: Independent Prediction of Neurosurgical Intervention

“…1,2 Studies have suggested an association between maxillofacial fractures and traumatic brain injury (TBI). [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Depending on the severity, TBI may be difficult to detect using current technology, potentially delaying treatment and worsening prognosis for patients. 4 A recent study suggested an association between Le Fort type fractures and more severe TBI.…”