title: Changing characteristics of facial fractures treated at a regional, level 1 trauma center, from 2005 to 2010: an assessment of patient demographics, referral patterns, etiology of injury, anatomic location, and clinical outcomes.
abstract: BACKGROUND
  Despite improvements in automotive safety, motor vehicle collision (MVC)-related facial fractures remain common and represent preventable injuries. This study examines the changing characteristics of facial fractures treated at a regional, level I trauma center, from 2005 to 2010.
  
  
  METHODS
  We identified all patients with facial fractures admitted to our hospital, from 2005 to 2010, by querying the North Carolina Trauma Registry, using International Classification of Diseases, Ninth Revision codes. Prospectively collected data, sorted by year, were descriptively analyzed for demographics, referral patterns, etiology, anatomic location, and clinical outcomes.
  
  
  RESULTS
  Number of patients with facial fractures increased from 201 per year to 263 per year (total n = 1508). Although transport distances remained constant at ∼85 miles, standard deviation increased from 37 to 68 miles. Transport time increased from 87 to 119 minutes. Referrals came from 28 surrounding counties in 2005 and 43 counties in 2010. Regarding etiology, MVCs decreased from 40% to 27%, all-terrain vehicle crashes decreased from 6% to 2%, falls increased from 8% to 19%, and bicycle accidents increased from 3% to 6%. Regarding anatomic location, frontal sinus fractures increased from 8% to 37%, zygomaticomaxillary fractures increased from 9% to 18%, nasoethmoid fractures decreased from 12% to 6%, orbital floor fractures decreased from 6% to 3%, and mandible fractures decreased from 28% to 18%. Single-site fractures increased from 75% to 90%. Length of intensive care unit and hospital stay remained stable at 3 and 7 days, respectively.
  
  
  CONCLUSIONS
  Despite a decrease in MVC-related facial fractures, the overall increase in facial fractures referred to our trauma center is due to a growing number of patient transfers from rural hospitals, where a paucity of qualified surgeons may exist.
authors.affiliation: The University of North Carolina at Chapel Hill, Ste 7038, Burnett Womack, CB 7195, Chapel Hill, NC 27516–7195, USA.
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Roden
authors.forename: Winnie
authors.initials: W
authors.lastname: Tong
authors.forename: Matthew
authors.initials: M
authors.lastname: Surrusco
authors.forename: William W
authors.initials: WW
authors.lastname: Shockley
authors.forename: John A
authors.initials: JA
authors.lastname: Van Aalst
authors.forename: Charles S
authors.initials: CS
authors.lastname: Hultman
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D001642:Bicycling; D005147:Facial Bones / Q000293:injuries*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D009657:North Carolina / Q000453:epidemiology; D010360:Patient Transfer / Q000706:statistics & numerical data; D012042:Registries; D012887:Skull Fractures / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D014193:Trauma Centers / Q000706:statistics & numerical data*