title: Emergency department visits with facial fractures among children and adolescents: an analysis of profile and predictors of causes of injuries.
abstract: OBJECTIVE
  The objectives of this study were to provide nationally representative estimates of hospital-based emergency department (ED) visits for facial fractures in children and adolescents, examine the burden associated with such visits, identify common types of facial fracture, and examine the role of patient-related demographic factors on the causes of facial fractures.
  
  
  METHODS
  The Nationwide Emergency Department Sample for 2008 to 2010 was used. All ED visits with a diagnosis of facial fractures in those no older than 21 years were selected. Demographic characteristics, types of facial fracture, causes of injuries, and hospital charges were examined.
  
  
  RESULTS
  During the study period, 336,124 ED visits were for facial fractures in those no older than 21 years. Late adolescents (18 to 21 yr old) and middle adolescents (15 to 17 yr old) comprised 45.6% and 26.6% of all ED visits, respectively. Male patients comprised 74.7% of ED visits. The most common facial fractures were those of the nasal bones and mandible. Younger children were more likely to have falls, pedal cycle accidents, pedestrian accidents, and transport accidents, whereas older groups were more likely to have firearm injuries, motor vehicle traffic accidents, and assaults (P < .05). Female patients were more likely to have falls, motor vehicle traffic accidents, and transport accidents, whereas male patients were more likely to have firearm injuries, pedal cycle accidents, and assaults (P < .05). Those residing at low annual income household levels were at a high risk for having firearm injuries, motor vehicle traffic accidents, and transport accidents (P < .05).
  
  
  CONCLUSIONS
  Late adolescents, middle adolescents, and male patients comprise a significant proportion of these ED visits. Age, gender, and household income levels are significantly associated with the causes of facial fracture injuries.
authors.affiliation: Associate Professor, Department of Orthodontics, College of Dentistry-University of Iowa, Iowa City, IA.
authors.forename: Veerasathpurush
authors.initials: V
authors.lastname: Allareddy
authors.affiliation: Pediatric Dental Resident, Texas A&M University Baylor College of Dentistry, Dallas, TX.
authors.forename: Abraham
authors.initials: A
authors.lastname: Itty
authors.affiliation: General Practice Resident, Carolinas Medical Center, Charlotte, NC.
authors.forename: Elyse
authors.initials: E
authors.lastname: Maiorini
authors.affiliation: Orthodontic Resident, Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA.
authors.forename: Min Kyeong
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Research Assistant, Department of Pediatric Critical Care, Case Medical School-Rainbow Babies Hospital, Cleveland, OH.
authors.forename: Sankeerth
authors.initials: S
authors.lastname: Rampa
authors.affiliation: Assistant Professor, Department of Pediatric Critical Care, Case Medical School-Rainbow Babies Hospital, Cleveland, OH.
authors.forename: Veerajalandhar
authors.initials: V
authors.lastname: Allareddy
authors.affiliation: Instructor, Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA. Electronic address: romesh.aus@gmail.com.
authors.forename: Romesh P
authors.initials: RP
authors.lastname: Nalliah
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000367:Age Factors; D001642:Bicycling / Q000293:injuries; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D016021:Epidemiologic Studies; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D005596:Fractures, Closed / Q000453:epidemiology; D005597:Fractures, Open / Q000453:epidemiology; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D008337:Mandibular Fractures / Q000453:epidemiology; D009295:Nasal Bone / Q000293:injuries; D012189:Retrospective Studies; D012737:Sex Factors; D012887:Skull Fractures / Q000191:economics / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000453:epidemiology; D055815:Young Adult