Epidemiological Survey of Head and Neck Injuries and Trauma in the United States

Abstract

Background Trauma to the head and neck results in a range of injuries, spanning minor lacerations to life threatening airway compromise. Few studies provide a global analysis of trauma-injuries to the head and neck region. We aim to 1) describe head and neck injury prevalence, 2) quantify procedures, and 3) investigate outcomes, including predictors of admission and mortality. Study Design The 2011 U.S. Nationwide Emergency Department Sample was queried for encounters with a primary diagnosis of head and neck injury, as categorized by the Barell Injury Matrix. Weighted estimates for demographic data, injury category, and mechanism were extracted. Predictors of mortality and admission were determined by multivariable logistic regression. Results We identified 131 million ED encounters. A weighted total of 5,418,539 visits were related to primary injuries of the head and neck. Average patient age was 30 years (SE=0.4) and 56.8% were male. Sixty-four percent of injuries were attributed to fall or blunt trauma. Open wounds comprised 41.8% of injuries. The most common procedure was laceration repair (70%). The majority of patients (97%) were discharged home. Mortality rate was less than 1%. Predictors of admission and mortality (p<0.05) included multiple trauma, trauma to blood vessels, and burns. Other risk factors included foreign body, older age, and male gender. Conclusions We provide a landscape analysis of U.S. head and neck trauma, including investigation of types of injuries, and risk factors for admission and mortality. These data have broad implications for surgical training and resource management.

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