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A large volume of reports detailing a marked increase in Mucormycosis infections in India has filtered its way into world news articles. These patients frequently have 2 risk factors: recent treatment of COVID-19 with high dose steroids, and uncontrolled diabetes. Recently, at the University of Tennessee Medical Center in Knoxville, we successfully treated an uncontrolled diabetic patient with rhinocerebral Mucormycosis as a sequela of his COVID-19 treatment.

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In individuals who have sustained maxillofacial trauma, inadequate nutrition is often a sequela and may lead to complications. The purpose of this study was to investigate the association between preoperative laboratory values and postoperative complications in patients with maxillofacial trauma requiring surgical intervention.A retrospective cohort study of patients with maxillofacial trauma requiring surgical repair from 2014 to 2020 was performed at a single academic Level I Trauma Center. The primary predictor variables were preoperative laboratory values including serum albumin, white blood cell count, absolute neutrophil count, and lymphocyte count. Complications related to surgical reconstruction of facial injuries represented the primary outcome variable.The patient cohort included 152 patients, of whom 50 (32.9%) were female. When controlling for all other variables, female gender (odds ratio = 2.08, 95% confidence interval, 1.02-4.21; P = 0.04) and number of procedures performed (P = 0.02) were the only statistically significant predictors of postoperative complications. There were no significant differences between the complication groups for age (P = 0.89), injury severity score (P = 0.59), hospital length of stay (P = 0.30), serum albumin (P = 0.86), hemoglobin (P = 0.06), white blood cell count (P = 0.20), absolute neutrophil count (P = 0.95), lymphocyte count (P = 0.23), or absolute neutrophil/lymphocyte count ratio (P = 0.09).In this study, it was found that only gender and the number of procedures performed significantly predicted postoperative complications, while preoperative nutritional laboratory values did not. Further study with a larger cohort of patients is likely required.

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Purpose The objective of the following study was to determine what factors, if any, are associated with increased hospitalization charges amongst pediatric patients who sustain maxillofacial fractures. Methods This retrospective cohort study was conducted using the Kids’ Inpatient Database (KID). The primary predictor variables were a set of heterogenous variables that included patient characteristics, injury characteristics, and hospitalization outcomes. The primary outcome variable was total charges (US dollars). Linear regression was used to determine independent risk factors for increased/decreased hospital charges. Results The final sample consisted of 50,434 pediatric patients who suffered at least one facial fracture. The mean age of the study sample was 9.72 years (SD, 6.84 years). Relative to Black patients, Hispanic patients added $12,812 (P < 0.05) in hospital charges. Relative to fall, motorcycle accident (P < 0.05), car accident (P < 0.05), and firearm assault (P < 0.05) were each independently associated with increased hospital charges. Mandible fractures (P < 0.05) added $12,208 in hospital whereas malar & maxillary fractures (P < 0.05) added $8,564 in hospital charges. Most notably, panfacial fractures (P < 0.05) added $32,364 in hospital charges. Other fractures of the body were each independently associated with increased hospital charges. Several internal organ injuries were each independently associated with increased hospital charges Conclusion There is an opportunity for cost reduction in the management of pediatric maxillofacial trauma. This includes promptness in definitive repair and easy access to interpreters for non-English speaking patients. Cost-efficient approaches to patient care should be recognized and utilized to the patient and family benefit whenever possible.

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