PDF(Pubmed)
Abstract：
Introduction Traumatic facial injuries, leading to facial fractures represent a significant subset of traumatic events, with age emerging as a crucial determinant influencing both their etiology and outcomes. Understanding the age-related patterns of traumatic facial fractures is essential for developing targeted prevention and management strategies. In this context, the Appalachian tri-state area stands as an underexplored region concerning this issue, necessitating comprehensive research to elucidate the nuances of age-related traumatic facial fractures within this geographic context. Methods This retrospective study delves into the age-related patterns of traumatic facial fractures within the Appalachian tri-state area, drawing upon patient records from Cabell Huntington Hospital and Saint Mary\'s Medical Center spanning a five-year period. The study cohort encompasses 623 patients categorized into three age groups: individuals aged <22 years, those aged 22-65 years, and individuals over 65 years. Data analysis involves meticulous examination of mechanisms of injury, injury severity scores (ISSs), hospital length of stay, and the prevalence of surgical interventions across different age cohorts. Results Out of 623 patients, 104 (16.7%) were under 22 years old, 367 (58.9%) were between 22 and 65 years old, and 152 (24.4%) were over 65 years old. The majority were male (70%). Falls were the most common cause of facial fractures in patients over 65 (78%), while assaults were predominant in the 22-65 age group (24%), and motor vehicle collisions (MCVs) in those under 22 (34%). The median ISS and hospital stay durations were similar across age groups. 28% of patients underwent surgery, with significant variation among age groups (p<0.001): 38% for <22 years, 33% for 22-65 years, and 11% for >65 years. Mandibular fractures were more prevalent in younger patients, with rates of 12% for <22 years compared to 5.3% for >65 years. Logistic regression analysis revealed that patients aged 22-65 had 4.10 times higher odds (95% CI=2.38, 7.45, p<0.001) of undergoing surgery, while those under 22 had 5.14 times higher odds (95% CI=2.73, 10.0, p<0.001) compared to those over 65. Significant associations were found for mandibular and bilateral mandibular outcomes in patients aged 22-65 years. Discussion These findings underscore the imperative for tailored prevention strategies and age-specific treatment protocols to optimize patient outcomes. Fall prevention initiatives for the elderly and interventions addressing sports-related injuries for younger individuals are paramount. Moreover, the study highlights the necessity of specialized care protocols for elderly patients to minimize hospital stay durations and manage age-related comorbidities effectively. Moving forward, further research should address limitations, validate findings, and explore the efficacy of specific interventions, thereby paving the way for enhanced preventive measures and management strategies tailored to the diverse age cohorts affected by traumatic facial fractures in the Appalachian region.
摘要：
引言创伤性面部损伤,导致面部骨折是创伤事件的重要子集，随着年龄成为影响其病因和结局的关键决定因素。了解创伤性面部骨折的年龄相关模式对于制定有针对性的预防和管理策略至关重要。在这种情况下，阿巴拉契亚三州地区是一个关于这个问题的未充分开发的地区，需要进行全面的研究，以阐明在这种地理背景下与年龄相关的创伤性面部骨折的细微差别。方法这项回顾性研究探讨阿巴拉契亚三州地区创伤性面部骨折的年龄相关模式，从卡贝尔亨廷顿医院和圣玛丽医疗中心的病人记录，为期五年。该研究队列包括623名患者，分为三个年龄组：年龄<22岁，22-65岁的人，以及65岁以上的个人。数据分析涉及对损伤机制的细致检查，损伤严重程度评分（ISS），住院时间,以及不同年龄队列中手术干预的患病率。结果623例患者中,104人(16.7%)未满22岁,367（58.9％）年龄在22至65岁之间，152人(24.4%)超过65岁。大多数是男性（70％）。跌倒是65岁以上（78%）患者面部骨折的最常见原因，虽然攻击在22-65岁年龄段占主导地位(24%)，以及22岁以下儿童的机动车碰撞(MCV)(34%)。不同年龄段的ISS中位数和住院时间相似。28%的患者接受了手术，年龄组间有显著差异(p<0.001)：<22岁时为38%，33%，22-65年，以及超过65年的11%。下颌骨骨折在年轻患者中更为普遍，<22年的比率为12%，而>65年的比率为5.3%。Logistic回归分析显示,22~65岁的患者接受手术的几率是手术的4.10倍(95%CI=2.38,7.45,p<0.001),而22岁以下的人群的几率是65岁以上人群的5.14倍（95％CI=2.73，10.0，p<0.001）。在22-65岁的患者中，下颌和双侧下颌结局存在显着相关性。讨论这些发现强调了量身定制的预防策略和针对特定年龄的治疗方案以优化患者结果的必要性。针对老年人的跌倒预防措施和针对年轻人的运动相关伤害的干预措施至关重要。此外，该研究强调了为老年患者提供专门护理方案的必要性,以最大限度地减少住院时间并有效管理与年龄相关的合并症.往前走,进一步的研究应该解决局限性，验证调查结果，并探索具体干预措施的有效性，从而为针对阿巴拉契亚地区受创伤性面部骨折影响的不同年龄段的人群，加强预防措施和管理策略铺平了道路。
