Predictors of Facial Fractures in Trauma Patients: Retrospective Review at a Level I Trauma Center

Abstract

Background The incidence and causes of facial fractures differ between patients, but patterns arise within populations. These patterns vary by gender, age, and between countries. This study aims to determine variables to identify patients at risk for facial fractures in a United States trauma population. Methods This is a single-center study of Trauma Registry data, inclusive of years July 1, 2016, to January 31, 2022. Inclusion criteria were based upon all trauma patients. Confirmation of a non-isolated facial fracture (dependent variable) was verified using ICD10 diagnosis codes. A logistic regression was performed in SPSS to ascertain the effects of predictor variables on the likelihood that a trauma patient will experience a facial fracture. Results 20377 patients were included in the analysis based upon the requirements specified in the methods section; 1575 (7%) had a positive facial fracture. The logistic regression model was statistically significant (N = 18507, P < .01). Significant risk factors for facial fracture identified included helicopter transport (OR = 1.35, P < .01) and increasing injury severity scores (OR = 1.07, P < .01). Modes of injury most likely to predict facial fracture included assault (OR = 6.62, P < .01), moped (OR = 2.02, P < .01), and motorcycle trauma (OR = 1.55, P < .01). The discharge disposition most likely among facial fracture patients included short-term general hospital (OR = 1.71, P < .01) and intermediate care facility (OR = 4.47, P < .01). Conclusions Patients with traumatic injuries from assault, moped, and motorcycle accidents were more likely to present with facial fractures. These patients had more severe injuries, seen as increased ISS scores, higher likelihood of transport by helicopter, and the need for additional care after discharge.

Comparative Analysis of Open and Closed Nasal Fractures in Trauma Settings: Mechanisms, Intent, Surgical Interventions, and Outcomes

“…Consistent with past literature, injury severity emerged as the strongest predictor in our regression model, with every 1-point increase in ISS conferring 0.4% higher adjusted odds of open nasal fracture [23] [20]. While the effect size appears modest, patients often present with a high ISS in the setting of penetrating trauma and polytrauma, amplifying this association.…”

“…Moreover, the increased rates of turbinectomy, septoplasty, and other nasal diagnostic and lesion excision procedures in open fractures re ect the broader scope of nasal injury and the need for comprehensive nasal assessment and treatment in these cases [16], [19]. The higher incidence of operations on the nose, mouth, pharynx, respiratory system, cardiovascular system, and digestive system further illustrates the multidimensional impact of open nasal fractures, often extending beyond the nasal structure [16], [20], [21].…”

“…Unintentional open nasal fractures have a variety of possible etiologies, ranging from falls to motor vehicle collisions. Regardless of intent, open nasal fractures signal high-energy transfer to the facial area and require prompt recognition and management [20].…”