The Cost and Inpatient Burden of Treating Mandible Fractures: A Nationwide Inpatient Sample Database Analysis

Pena, Israel; Roberts, Laura; Guy, W. Marshall; Zevallos, José P.

doi:10.1177/0194599814542590

Cited by 46 publications

(33 citation statements)

References 32 publications

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“…The mean length of hospital stay for a mandible fracture is 2.65 days, and the mean hospitalization cost is $35 804. 13 Since the first commercially successful bicycle helmet, a polystyrene-lined hard shell, was released in 1975, most bicycle helmet designs have not added significant protection of the face. 14 Currently, the Consumer Product Safety Commission determines bicycle helmet standards in the United States.…”

Section: Discussionmentioning

confidence: 99%

Association Between Conventional Bicycle Helmet Use and Facial Injuries After Bicycle Crashes

Benjamin

Hills

Knott

et al. 2019

JAMA Otolaryngol Head Neck Surg

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Bicycling is an increasingly common activity in the United States that is often associated with fall injuries to the head and face. Although helmets lessen head injury, their role in reducing facial injuries is less clear; therefore, it is important to understand the protective capacity for the face in current helmet design. OBJECTIVE To estimate the conventional bicycle helmet's association with the rate of facial injury after bicycle crashes. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study accessed records from January 1, 2010, to December 31, 2014, from the National Trauma Databank, which collects data from emergency departments in US hospitals. Each record pertained to 1 emergency department admission for a bicycle crash. The National Trauma Databank registry data are collected and recorded by incident, which is equivalent to an injury-related hospital admission. All injuries involving patients aged 18 to 65 years for whom data on helmet use and injury were available were included. Statistical analysis was conducted from July 19 to October 17, 2016. EXPOSURES Helmeted and nonhelmeted bicycle crashes. MAIN OUTCOMES AND MEASURES Head and facial injuries among helmeted and nonhelmeted bicycle crashes. RESULTS A total of 85 187 facial injuries met inclusion criteria (patient age 18-65 years, availability of helmet use status, and type of injury). Demographic information on bicycle riders was frequently unavailable. Among all injuries, fractures to the head (11.6% [9854]) and face (11.3% [9589]) occurred at similar rates. Helmets reduced head fractures by 52% (from 14.0% [7623] to 7.3% [2231]) and head soft-tissue injuries by 30% (from 15.0% [8151] to 10.9% [3358]), but had lower rates in protecting against facial injuries. While reducing facial injuries overall, the amount of protection with helmet use varied with facial location of the injury. Reduction in facial fractures was 35% (95% CI, 31%-39%) for upper face, 28% (95% CI, 23%-32%) for mid face, and 21% (95% CI, 15%-26%) for the lower face. Helmets were less protective against facial soft-tissue injuries, with a reduction of 33% (95% CI, 30%-36%) in the upper face, 21% (95% CI, 16%-26%) in the mid face, and 2% (95% CI, 0%-6%) in the lower face. CONCLUSIONS AND RELEVANCE Although bicycle helmets provide some protection against facial injuries after bicycle crashes, the level of protection depends on the proximity of the injury to the helmeted head. The lower face is particularly vulnerable to injury despite helmet use.

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Section: Discussionmentioning

confidence: 99%

Association Between Conventional Bicycle Helmet Use and Facial Injuries After Bicycle Crashes

Benjamin

Hills

Knott

et al. 2019

JAMA Otolaryngol Head Neck Surg

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“…Regarding medical costs, a cross-sectional study using the 2009 NIS database and 1481 patients with isolated mandibular fractures [5] reported that the average per-patient treatment cost was $35,804, and that patients with a history of mental illness, cardiovascular disease, increased age, and substance abuse had higher costs; most patients with an isolated mandibular fracture requiring treatment were uninsured (47%) males with lower socioeconomic status; the incidence of alcohol abuse was 12% and mental illness incidence was 5.5%. The average hospital stay of alcoholics was 1 day longer, and their medical costs were $10,000 more than those of nonalcoholics.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, as the NIS is based on ICD-9 codes, the complication rate may have been underestimated. [5] Furthermore, Pena et al [5] pointed out that motor vehicle accidents and sports injuries have a higher likelihood of causing poly-trauma injuries, and an isolated mandibular trauma is most likely the result of an assault. Therefore, because the present study excluded polytrauma, a higher proportion of injuries resulting from assaults may have been included versus other causes of mandibular fractures.…”

Section: Limitationsmentioning

confidence: 99%

“…[1] Mandibular condylar fractures are the most common mandibular fractures, with an overall incidence of 18% to 57%, and incidence of 24% to 72% in children. [2–4] Mandible fractures are more common in males, [5] and common causes of traumatic facial injury include motor vehicle accidents, violence, sports-related trauma, falls, and industrial incidents. [2,3,5]…”

Section: Introductionmentioning

confidence: 99%

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Open reduction and internal fixation of mandibular condylar fractures

Kuang

He²,

Zheng³

et al. 2019

Medicine

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The purpose of this study was to compare outcomes of open reduction and internal fixation (ORIF) versus closed reduction (CR) for mandibular condylar fractures.Patients included in the National Inpatient Sample (NIS) database (2005–2014) who were admitted to the hospital for unilateral mandibular condylar fracture were included in the analysis. Patient characteristics and clinical outcomes were compared between those who received ORIF and those receiving CR. Logistic regression analysis was performed to estimate odds ratios (ORs) for each aspect of the main observed events.NIS data of 12,303 patients who underwent ORIF and 4310 patients who underwent CR were analyzed. Compared to CR, ORIF had an increased risk of longer hospital stay (adjusted OR [aOR] = 1.78, 95% confidence intervals [CIs] = 1.51–2.09), higher total medical cost (aOR = 2.57, 95% CI = 2.17–3.05), and hematoma development (aOR = 10.66, 95% CI = 1.43–75.59), but had a lower risk of having wound complications (aOR = 0.86, 95% CI = 0.79–0.93).Patients with mandibular condylar fractures who receive ORIF have greater risk of having an extended hospital stay, higher total medical costs, and hematoma development but lower risk of experiencing wound complications compared to those who receive CR.

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“…fratura de mandíbula corresponde a $35.804 o que pode constituir-se em um grande problema de saúde pública [24]. Christensen et al conduziram um estudo retrospectivo de 3 anos em um hospital escola em New Orleans (USA) para identificar fatores de risco para o desenvolvimento de complicações maiores após redução aberta e fixação interna de fraturas de mandíbula.…”

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Epidemiologia e desfechos clínicos do tratamento das fraturas faciais de um hospital público de Quito - Equador: um estudo retrospectivo de 5 anos

Teran¹

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AGRADECIMENTOSAgradeço a Deus que me deu forças e me permitiu continuar esta jornada cheia de sacrifício e satisfação. A Faculdade de Odontologia da Universidade de São Paulo pela oportunidade em realizar o convênio de Doutorado Interinstitucional -DINTER com a Universidade Central do Equador, dando todo suporte e aprendizado ao longo desta Pós-Graduação. A Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -CAPES do governo federal do Brasil, por aprovar este projeto DINTER, proporcionando oportunidade única na história da Odontologia do nosso país. A nossa Faculdade de Odontologia da Universidade Central do Equador pelo apoio e incentivo a mim como docente e agora como aluno de pós-graduação da USP. Agradeço, de uma forma muito especial a minha orientadora, Profa. Dra. Maria Cristina Zindel Deboni, que me ensinou com paciência e dedicação, e para a abertura de porta para um mundo maravilhoso da investigação científica. Atividade de abnegação e ao mesmo tempo de nobreza. Sempre procurando melhorar a qualidade de vida das pessoas. Agradeço, também, os professores Edgard Michel Crosato, Maria Gabriela Haye, Cláudio Mendes Panutti, Fausto Medeiros Mendes e todos os demais professores da FOUSP que esses anos deixaram suas atividades para ministrar o curso de Doutorado tão necessário ao nosso país. Agradeço aos meus colegas do doutorado e aos servidores não docentes da Universidade de São Paulo que nos entregaram, sem egoísmo, ajuda e companheirismo para seguir em frente. Agradeço a Universidade Central do Equador, por nos dar todas as facilidades para poder realizar este caminho tão complexo, mas tão agradável. Agradeço o Hospital Eugenio Espejo e ao Serviço de Cirurgia Bucomaxilofacial, e a todo o pessoal daquela instituição pelas posibilidades de realizar este trabalho. O IMPORTANTE É NÃO PARAR DE QUESTIONAR. Albert Einstein Palavras-chave: Epidemiologia. Ossos faciais. Fixação de fraturas. Complicações. ABSTRACT Lanas Terán GA. Epidemiology and clinical outcomes of facial fractures management in a public hospital in Quito -Ecuador: a five-year retrospective study [thesis]. São Paulo: Faculdade de Odontologia; 2018. Versão Corrigida.Regional epidemiological studies involving maxillofacial traumatology are important to assist in the development of more efficient ways of providing health care, to assess and improve the quality of these care and to manage strategies of prevention,

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The Cost and Inpatient Burden of Treating Mandible Fractures: A Nationwide Inpatient Sample Database Analysis

Cited by 46 publications

References 32 publications

Association Between Conventional Bicycle Helmet Use and Facial Injuries After Bicycle Crashes

Association Between Conventional Bicycle Helmet Use and Facial Injuries After Bicycle Crashes

Open reduction and internal fixation of mandibular condylar fractures

Epidemiologia e desfechos clínicos do tratamento das fraturas faciais de um hospital público de Quito - Equador: um estudo retrospectivo de 5 anos

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