Characteristics of Maxillofacial Trauma Among Alcohol and Drug Users

Goulart, Douglas Rangel; Durante, Letícia; Moraes, Márcio de; Asprino, Luciana

doi:10.1097/scs.0000000000002055

Cited by 21 publications

(22 citation statements)

References 17 publications

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“…9–11 One study found that mandible fractures were primarily caused by interpersonal violence in drug and alcohol users. 12 Our results are not only consistent with these previous general epidemiologic studies on facial trauma but also novel in demonstrating that homeless patients are at much higher risk for being assaulted and suffering mandible fractures.…”

Section: Discussionsupporting

confidence: 92%

A Cross-sectional Study of the Association between Homelessness and Facial Fractures

Nguyen

Grimes

Neuhaus

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: Little is known about the risk factors for facial fractures among homeless patients. We investigated the association between homelessness, mechanism of injury, and type of facial fracture in patients treated at an urban trauma center. Methods: Data for 2,221 adults with facial fractures were obtained retrospectively from a standardized registry of trauma patients at Zuckerberg San Francisco General Hospital from 2011 to 2016. Associations between homelessness and mechanism of injury, facial fracture type, and surgical repair type were evaluated with multivariate multinomial logistic regression analysis. Results: Among 2,221 patients with facial fractures, 12% were homeless and, compared with housed patients, more likely to be male, black, and test positive for drug and alcohol use (all P < 0.0001). They had lower injury severity scores but longer hospital stays and were more likely to be discharged to the community than to a rehabilitation facility (all P < 0.0001). After adjusting for confounding variables, homeless patients with facial fractures were nearly 3-fold more likely to have been assaulted than housed patients (OR = 2.8, 95% CI = 1.9–4.1, P < 0.0001) and twice as likely to have mandible fractures (OR = 2.0, 95% CI = 1.3–3.0, P = 0.0030) and to have surgery for these fractures (OR = 2.1, 95% CI = 1.2–3.7, P = 0.0110). Conclusions: Our novel results demonstrate that homeless patients with facial fractures are at much higher risk than the general population for being assaulted, suffering mandible fractures, and requiring surgery for these fractures. Further investigations could guide identification, treatment, and prevention efforts.

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Section: Discussionsupporting

confidence: 92%

A Cross-sectional Study of the Association between Homelessness and Facial Fractures

Nguyen

Grimes

Neuhaus

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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“…However, the particular increases of January and September could involve other more complex components as they correspond to dates of national and international celebration (national holidays and new year). These characteristics have been described as a trigger for acts of violence (intentional injuries) (3,8,24) and road traffic crashes (unintentional) (11) where mediators such as alcohol and drugs play an enhancing role (3,8,17,24,25). Unfortunately, the detail of this information, as stated in other studies of a similar nature, is not well documented in the emergency registers (24), a fact that was repeated in our study.…”

Section: Discussionmentioning

confidence: 99%

Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile

Werlinger¹,

Villalón²,

Duarte³

et al. 2019

Med Oral

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BackgroundDetermine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile.Material and MethodsDescriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups.Results2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation. The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p<0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2).ConclusionsThe profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records. Key words:Maxillofacial trauma, emergency department, multicenter study.

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“…A patient suspect of having a combined trauma should, therefore, always be checked by specialists of both disciplines, with available neurosurgical consultation as soon as possible. This can be a challenge due to the known large proportion of intoxicated patients [13][14][15][16][17][18][19].…”

Section: Brain Trauma In Combined Cmf-and Ot-patientsmentioning

confidence: 99%

Combined trauma in craniomaxillofacial and orthopedic-traumatological patients: the need for proper interdisciplinary care in trauma units

Mühlenfeld

Thoenissen

Verboket

et al. 2020

Eur J Trauma Emerg Surg

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Aim The primary aim of this study was to analyze frequency and characteristics of combined facial and peripheral trauma with consecutive hospitalization and treatment. Materials and methods The study included all patients with concomitant orthopedic-traumatolgical (OT) and craniomaxillofacial (CMF) injuries admitted to our level I trauma center in 2018. The data were collected by analysis of the institution's database and radiological reviews and included age, sex, injury type, weekday and time of presentation. All patients were examined and treated by a team of surgeons specialized in OT and CMF directly after presentation. Results A total number of 1040 combined OT and CMF patients were identified. Mean age was 33.0 ± 26.2 years. 67.3% (n = 700) were male patients. Primary presentation happened most frequently on Sundays (n = 199) and between 7 and 8 pm (n = 74). 193 OT fractures were documented, where cervical spine injuries were most frequent (n = 30). 365 facial and skull fractures were recorded. 10.8% of the 204 patients with fractures of the viscerocranium presented with at least one fracture of the extremity, 7.8% (16/204) with cervical spine fractures, 33.3% (68/204) with signs of closed brain trauma and 9.8% (20/204) with intracranial hemorrhage. Discussion The study shows a high frequency of combined facial with OT-injuries and brain damage in a predominantly young and male cohort. Attendance by interdisciplinary teams of both CMF and OT surgeons specialized in cervical spine trauma surgery is highly advisable for adequate treatment. Conclusion Diagnostics and treatment should be performed by a highly specialized OT and CMF team, with a consulting neurosurgeon in a level-1 trauma center to avoid missed diagnoses and keep mortality low.

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Characteristics of Maxillofacial Trauma Among Alcohol and Drug Users

Cited by 21 publications

References 17 publications

A Cross-sectional Study of the Association between Homelessness and Facial Fractures

A Cross-sectional Study of the Association between Homelessness and Facial Fractures

Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile

Combined trauma in craniomaxillofacial and orthopedic-traumatological patients: the need for proper interdisciplinary care in trauma units

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