Epidemiology of facial injury in blunt assault. Determinants of incidence and outcome in 802 patients.
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.


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


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


METHODS
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.
Greene
D
D
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, USA.
Raven
R
R
Carvalho
G
G
Maas
C S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005147:Facial Bones / Q000293:injuries; D005151:Facial Injuries / Q000453:epidemiology*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008337:Mandibular Fractures / Q000453:epidemiology / Q000601:surgery; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D012495:San Francisco / Q000453:epidemiology; D012737:Sex Factors; D012887:Skull Fractures / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D016896:Treatment Outcome; D014754:Violence; D014949:Wounds, Nonpenetrating / Q000453:epidemiology*