Abstract：
OBJECTIVE: The pediatric craniofacial trauma literature is limited to single institutions or short study periods. Herein, this study analyzes a national database over 10 years to delineate the epidemiology of pediatric craniofacial fractures and to identify risk factors for acute-level hospital course in the largest series to date.
METHODS: Utilizing the National Trauma Data Bank, pediatric craniofacial fractures admitted between 2010 and 2019 were identified. Descriptive analyses and multivariable regression were performed to identify risk factors for acute-level hospital course.
RESULTS: A total of 155,136 pediatric craniofacial fracture cases were reviewed, including cranial vault (49.0%), nasal (22.4%), midface (21.0%), mandibular (20.2%), and orbital floor fractures (13.7%). Midface and orbital floor fractures occurred commonly as multicraniofacial fractures. Cranial vault fractures were the most common among all age groups, but frequency declined with age. In contrast, facial fractures increased with age. Despite the inherent complexity of multicraniofacial trauma, isolated fractures remained a concern for acute-level hospital course.Cranial vault and midface fractures had an increased risk of intracranial injury and intensive care unit admission (P<0.001). Mandibular and midface fractures had an increased risk for cervical spine fracture and tracheostomy (P<0.001). Patient and injury-specific risk factors among the fractures with the strongest association for each outcome-cranial vault and mandible-were identified.
CONCLUSIONS: The inherent limitations of prior studies-geographical biases, small cohorts, and short-term study periods-were addressed. Describing the independent contribution of each craniofacial fracture to the risk of acute-level hospital course outcomes can be employed to better optimize risk stratification, counseling, and management.
METHODS: Utilizing the National Trauma Data Bank, pediatric craniofacial fractures admitted between 2010 and 2019 were identified. Descriptive analyses and multivariable regression were performed to identify risk factors for acute-level hospital course.
RESULTS: A total of 155,136 pediatric craniofacial fracture cases were reviewed, including cranial vault (49.0%), nasal (22.4%), midface (21.0%), mandibular (20.2%), and orbital floor fractures (13.7%). Midface and orbital floor fractures occurred commonly as multicraniofacial fractures. Cranial vault fractures were the most common among all age groups, but frequency declined with age. In contrast, facial fractures increased with age. Despite the inherent complexity of multicraniofacial trauma, isolated fractures remained a concern for acute-level hospital course.Cranial vault and midface fractures had an increased risk of intracranial injury and intensive care unit admission (P<0.001). Mandibular and midface fractures had an increased risk for cervical spine fracture and tracheostomy (P<0.001). Patient and injury-specific risk factors among the fractures with the strongest association for each outcome-cranial vault and mandible-were identified.
CONCLUSIONS: The inherent limitations of prior studies-geographical biases, small cohorts, and short-term study periods-were addressed. Describing the independent contribution of each craniofacial fracture to the risk of acute-level hospital course outcomes can be employed to better optimize risk stratification, counseling, and management.
摘要：
目的：儿童颅面外伤文献仅限于单一机构或短期研究。在这里，这项研究分析了一个超过10年的国家数据库,以描述儿童颅面骨折的流行病学,并确定了迄今为止最大系列中急性住院的危险因素.
方法：利用国家创伤数据库，2010年至2019年期间收治的儿童颅面骨折被确认.进行描述性分析和多变量回归分析，以确定急性住院过程的危险因素。
结果：共回顾了155,136例儿童颅面骨折病例，包括颅骨（49.0%），鼻部（22.4%），中间面（21.0%），下颌（20.2%），眶底骨折（13.7%）。中面和眶底骨折通常为多颅面骨折。颅骨穹顶骨折是所有年龄组中最常见的，但是频率随着年龄的增长而下降。相比之下,面部骨折随年龄增长而增加。尽管多颅面创伤固有的复杂性，孤立性骨折仍然是急性住院期间的一个问题.颅骨穹窿和面部中部骨折增加了颅内损伤和重症监护病房入院的风险（P<0.001）。下颌骨和中面骨折增加了颈椎骨折和气管造口术的风险（P<0.001）。确定了患者和特定于损伤的风险因素，这些因素与每种结果的相关性最强-颅骨和下颌骨。
结论：先前研究的固有局限性-地理偏见，小团体，和短期研究期间-都得到了解决。描述每个颅面骨折对急性住院过程结果的风险的独立贡献可以用来更好地优化风险分层，咨询,和管理。
方法：利用国家创伤数据库，2010年至2019年期间收治的儿童颅面骨折被确认.进行描述性分析和多变量回归分析，以确定急性住院过程的危险因素。
结果：共回顾了155,136例儿童颅面骨折病例，包括颅骨（49.0%），鼻部（22.4%），中间面（21.0%），下颌（20.2%），眶底骨折（13.7%）。中面和眶底骨折通常为多颅面骨折。颅骨穹顶骨折是所有年龄组中最常见的，但是频率随着年龄的增长而下降。相比之下,面部骨折随年龄增长而增加。尽管多颅面创伤固有的复杂性，孤立性骨折仍然是急性住院期间的一个问题.颅骨穹窿和面部中部骨折增加了颅内损伤和重症监护病房入院的风险（P<0.001）。下颌骨和中面骨折增加了颈椎骨折和气管造口术的风险（P<0.001）。确定了患者和特定于损伤的风险因素，这些因素与每种结果的相关性最强-颅骨和下颌骨。
结论：先前研究的固有局限性-地理偏见，小团体，和短期研究期间-都得到了解决。描述每个颅面骨折对急性住院过程结果的风险的独立贡献可以用来更好地优化风险分层，咨询,和管理。
