title: Trends in maxillofacial trauma: a comparison of two cohorts of patients at a single institution 20 years apart.
abstract: OBJECTIVE
  The purpose of this study was to compare and characterize 2 cohorts of patients with maxillofacial fractures within the same institution over 2 6-year time frames 20 years apart.
  
  
  METHODS
  A retrospective review of patients with maxillofacial fractures at the authors' institution from 2004 to 2010 was performed, and a comparison was made with the authors' experience from 1984 to 1990.
  
  
  RESULTS
  The 1990 study showed 458 maxillofacial fractures (152 midface and 306 mandibular fractures). In the 2010 study, there were 1,731 maxillofacial fractures (1,313 midface and 418 mandibular fractures). There were significant differences in the mechanism of injury between the 1990 and 2010 studies: assaults decreased from 48.8% to 29.7%, motor vehicle collisions decreased from 39.1% to 29.6%, and falls increased from 3.6% to 22.1%. Comparison by age categories showed major changes in the following groups: maxillofacial fractures in patients 21 to 40 years old decreased from 61.7% to 35.3%, those in patients 41 to 65 years old increased from 13.1% to 35.4%, and those in patients at least 66 years old (elderly) increased from 0.2% to 14.5%. All these changes were statistically significant (P < .0001).
  
  
  CONCLUSIONS
  Maxillofacial trauma has changed significantly over the past 2 decades in the authors' institution. A decrease in assault-related injuries in the younger populations and an increase in the incidence of falls in the elderly were the main differences. There was a significant increase in elderly patients with maxillofacial trauma. This change emphasizes the need for adequate prevention programs and appropriate maxillofacial surgery teams to manage these injuries in the older patient.
authors: Former Assistant Clinical Professor, Division of Oral and Maxillofacial Surgery, MetroHealth Medical Center, Cleveland, OH. Electronic address: alanymartinez@icloud.com.
authors: Alan Y
authors: AY
authors: Martinez
authors: Associate Professor, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, MetroHealth Medical Center, Cleveland, OH.
authors: John J
authors: JJ
authors: Como
authors: Clinical Staff, Center for Connected Care, Cleveland Clinic, Cleveland, OH.
authors: Maidana
authors: M
authors: Vacca
authors: Regional Data Manager, Northern Ohio Trauma System, Cleveland, OH.
authors: Michael J
authors: MJ
authors: Nowak
authors: Research Biostatistician, Case Western University/MetroHealth Medical Center, Cleveland, OH.
authors: Charles L
authors: CL
authors: Thomas
authors: Associate Professor, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, MetroHealth Medical Center, Cleveland, OH.
authors: Jeffrey A
authors: JA
authors: Claridge
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001265:Athletic Injuries / Q000453:epidemiology; D015331:Cohort Studies; D005147:Facial Bones / Q000293:injuries; D006801:Humans; D008337:Mandibular Fractures / Q000453:epidemiology / Q000401:mortality; D008446:Maxillofacial Injuries / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D012189:Retrospective Studies; D012887:Skull Fractures / Q000453:epidemiology* / Q000401:mortality; D014754:Violence / Q000706:statistics & numerical data; D055815:Young Adult