Traumatic Brain Injury in Trauma Patients With Isolated Facial Fractures
| Autor: | Justin C. McCarty, Edward J. Caterson, Jennifer Siu, Elizabeth Kiwanuka, Shekhar K. Gadkaree |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Moderate to severe
Pediatrics medicine.medical_specialty Traumatic brain injury Aftercare Logistic regression 03 medical and health sciences 0302 clinical medicine Brain Injuries Traumatic Prevalence Medicine Humans Glasgow Coma Scale 030223 otorhinolaryngology Retrospective Studies Skull Fractures business.industry Surrogate endpoint 030206 dentistry General Medicine Nasal bone medicine.disease Logistic Models nervous system Otorhinolaryngology Maxilla Concomitant Surgery business |
| Zdroj: | The Journal of craniofacial surgery. 31(5) |
| ISSN: | 1536-3732 |
| Popis: | Background Diagnosis of traumatic brain injury (TBI), and specifically mild TBI (mTBI), is a diagnostic challenge which can delay diagnosis preventing early intervention and follow-up care. Facial fractures represent an objective surrogate marker for potential force transmission to the neural cavity. The authors' objective was to characterize the prevalence of TBI in trauma patients with isolated facial fractures stratified by injury severity. Methods The authors performed a retrospective cross-sectional study of the National Trauma Databank (NTDB) from 2007 to 2014 assessing a total of 1,867,761 participants identified as having a TBI and 306,785(60.2%) had an isolated facial fracture using ICD-9 codes. TBI severity was subdivided using Glasgow Coma Scale into mTBI and moderate-to-severe TBI. Logistic regression assessed odds of mTBI and moderate-to-severe TBI with different isolated facial fractures adjusted for injury severity. Results Trauma patients with isolated facial fractures of the nasal bone, mandible, malar region and maxilla, orbital floor, and alveolar and palate had a concomitant prevalence of mTBI ranging from 21.3% to 46.0% and moderate-to-severe TBI ranging from 7.3% to 18.4%. Mandibular fractures had the lowest odds of mTBI and moderate to severe TBI while alveolar and palate fractures had the highest odds of mTBI [OR3.20,95%CI (3.11-3.30)] and moderate to severe TBI [OR3.83,95%CI (3.65-4.01)]. Conclusions Isolated facial fractures have a high prevalence of mTBI at all injury severity levels. Clinicians can use the presence of facial fractures in trauma patients to serve as clinical markers for TBI, without distracting from already existing trauma protocols and their focus on treatment of immediate life-threatening injuries raising both awareness and potential for early intervention. |
| Databáze: | OpenAIRE |
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