The effect of alcohol on facial Trauma outcomes: an analysis of the National Trauma Data Bank.

Autor: Paw E; Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA. Electronic address: epaw1@jhu.edu., Canner JK; Johns Hopkins Department of Surgery, Division of Acute Care Surgery, Trauma, Emergency Surgery, and Critical Care, Baltimore, MD, USA., Haut ER; Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA; Johns Hopkins Department of Surgery, Division of Acute Care Surgery, Trauma, Emergency Surgery, and Critical Care, Baltimore, MD, USA; Johns Hopkins Department of Anesthesiology and Critical Care Medicine, Department of Emergency Medicine, The Johns Hopkins University School of Medicine, The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD, USA., Manukyan M; Johns Hopkins Department of Surgery, Division of Acute Care Surgery, Trauma, Emergency Surgery, and Critical Care, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: International journal of oral and maxillofacial surgery [Int J Oral Maxillofac Surg] 2020 Sep; Vol. 49 (9), pp. 1174-1182. Date of Electronic Publication: 2020 Feb 01.
DOI: 10.1016/j.ijom.2020.01.016
Abstrakt: Maxillofacial trauma costs emergency departments approximately one billion dollars annually. Facial trauma has increased since 2000 and has been attributed to both increased use of computed tomography and interpersonal violence. Alcohol, male sex, and age 18-35 years are significant risk factors for interpersonal violence. This study is novel in using a large database to look at the effect of alcohol on clinical outcomes in facial trauma. A data analysis was performed in Stata/MP 14.2 using variables coded from the National Trauma Data Bank (NTDB); logistic regression was applied. A total 580,313 patient records were analyzed. Operations for facial fractures were performed in 20.19% of cases (n = 117,139). A positive alcohol test reduced the odds of requiring operative fixation in both the unadjusted (odds ratio (OR) 0.8, 95% confidence interval (CI) 0.79-0.82, P < 0.001) and adjusted (OR 0.67, 95% CI 0.66-0.68, P < 0.001) models. Age and being struck (adjusted OR 1.99, 95% CI 1.91-2.07, P < 0.001) or shot (adjusted OR 1.95, 95% CI 1.84-2.06, P < 0.001) had a significant effect on operative fixation. Injury mechanisms related to interpersonal violence appeared to have higher operative fixation rates. This study did not find a correlation between acute intoxication and the need for an operative intervention. This further demonstrates the multifactorial nature of facial trauma and stresses the importance of injury and violence prevention on clinical outcomes.
(Copyright © 2020 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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