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Epidemiology of Facial Injury in Blunt Assault: Title and subTitle BreakDeterminants of Incidence and Outcome in 802 Patients FREE

David Greene, MD; Raymond Raven, MD; Gerard Carvalho; Corey S. Maas, MD
Arch Otolaryngol Head Neck Surg. 1997;123(9):923-928. doi:10.1001/archotol.1997.01900090029005
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Background:  Facial assault trauma has reached epidemic proportions. While the biomechanics of injury, methods of repair, and general demography of blunt facial trauma are well known, statistical associations between epidemiological factors, incidence, and outcome are poorly understood.

Objectives:  To provide a comprehensive epidemiological survey of this patient population. To assess factors determining outcome and pattern of injury.

Design:  Retrospective review of 802 patients admitted with blunt assault facial trauma. Statistical analysis of associations between epidemiological factors, incidence, and outcome with X2 test, 2-tailed t test, and Fisher exact test.

Setting:  Urban university and county hospital.

Results:  Statistically significant associations are demonstrated between gender and the context of assault, incidence of armed assault, presence of fracture, and rate of intoxication at injury. Poor prognostic indicators for outcome include use of tobacco and presence of a mandible fracture. Open reduction and internal fixation were found to bear a higher complication rate only in mandible fractures.

Conclusions:  While choice of treatment carries a statistically significant association with outcome, social variables, including gender, tobacco use, intoxication, and low socioeconomic status, produce dramatic worsening of both injury incidence and outcome.Arch Otolaryngol Head Neck Surg. 1997;123:923-928

REFERENCES

Strom C.  Injuries due to violent crime . Med Sci Law . 1992;;32:123-132.
Adi M, Ogden GR, Chisholm DM.  An analysis of mandibular fractures in Dundee, Scotland (1977-1985) . Br J Oral Maxillofac Surg . 1990;;28:194-199.
Eiskjaer S.  Epidemiology of violence in a Danish municipality: changes in severity during the 1980s . Dan Med Bull . 1992;;39:83-85.
Fothergill N.  A prospective study of assault victims attending a suburban A and E department . Arch Emerg Med . 1990;;7:172-177.
Hall S.  Mandibular fractures in an American inner city: the Harlem Hospital Center experience . J Natl Med Assoc . 1991;;83:421-423.
Hussain K.  A comprehensive analysis of craniofacial trauma . J Trauma . 1994;; 36:34-47.
Conway T.  The internist's role in addressing violence: a review of current recommendations and a model for intervention . Arch Intern Med . 1996;;156:951-956.
Eastman AB.  Blood in our streets: the status and evolution of trauma care systems . Arch Surg . 1992;;127:677-681.
Shepard J.  Pattern, severity and etiology of injuries in victims of assault . J R Soc Med . 1990;;83:75-78.
Busuito MJ, Smith DJ, Robson MC.  Mandibular fractures in an urban trauma center . J Trauma . 1986;;26:826-829.
Eid K, Lunch D, Whitaker L.  Mandible fractures: the problem patient . J Trauma . 1976;;16:658-661.
Zachariades N.  Facial trauma in women resulting from violence by men . J Oral Maxillofac Surg . 1990;;48:1250-1253.

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Strom C.  Injuries due to violent crime . Med Sci Law . 1992;;32:123-132.
Adi M, Ogden GR, Chisholm DM.  An analysis of mandibular fractures in Dundee, Scotland (1977-1985) . Br J Oral Maxillofac Surg . 1990;;28:194-199.
Eiskjaer S.  Epidemiology of violence in a Danish municipality: changes in severity during the 1980s . Dan Med Bull . 1992;;39:83-85.
Fothergill N.  A prospective study of assault victims attending a suburban A and E department . Arch Emerg Med . 1990;;7:172-177.
Hall S.  Mandibular fractures in an American inner city: the Harlem Hospital Center experience . J Natl Med Assoc . 1991;;83:421-423.
Hussain K.  A comprehensive analysis of craniofacial trauma . J Trauma . 1994;; 36:34-47.
Conway T.  The internist's role in addressing violence: a review of current recommendations and a model for intervention . Arch Intern Med . 1996;;156:951-956.
Eastman AB.  Blood in our streets: the status and evolution of trauma care systems . Arch Surg . 1992;;127:677-681.
Shepard J.  Pattern, severity and etiology of injuries in victims of assault . J R Soc Med . 1990;;83:75-78.
Busuito MJ, Smith DJ, Robson MC.  Mandibular fractures in an urban trauma center . J Trauma . 1986;;26:826-829.
Eid K, Lunch D, Whitaker L.  Mandible fractures: the problem patient . J Trauma . 1976;;16:658-661.
Zachariades N.  Facial trauma in women resulting from violence by men . J Oral Maxillofac Surg . 1990;;48:1250-1253.

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