%0 Journal Article
%T Cost-Benefit Analysis of the CT of the Face in the Evaluation of Traumatic Facial Fractures in an Appalachian Tri-state Geriatric Population.
%A Giangrosso GV
%A Bayliss T
%A Rahimpour A
%A Murphy A
%A Ray P
%A Denning D
%A Barry R
%J Cureus
%V 16
%N 7
%D 2024 Jul
%M 39099990
暂无%R 10.7759/cureus.63830
%X OBJECTIVE: This study aimed to evaluate the cost vs. benefits of the CT face imaging study in the trauma workup of those over the age of 65.
METHODS: We performed a retrospective chart review of 169 trauma patients in our trauma database aged 65 years or older who underwent a CT of the head, a CT of the face, or a CT of the head and CT of the face that resulted in findings of a facial fracture from 2017-2022. Injuries and the treatment they received were documented. If a patient underwent both a CT of the face and a CT of the head, then the author first viewed the CT of the head, documented any injury, and then recorded treatment based on the CT of the head. The CT of the face was then viewed, injuries were recorded, and treatment based on the CT of the face was documented. Statistical analysis was then performed using the paired T-test, McNemar test, and number needed to harm analysis.
RESULTS: Of the 169 patients sampled, 159 underwent both CT of the head and the face. There were no patients who underwent a CT of the face exclusively, and only 10 patients underwent a CT of the head exclusively. Of the 159 that had both a CT of the head and the face, the average number of injuries noted on CT of the head + CT of the face vs. CT of the head was 2.42 vs. 1.36, P<.0.0001. The number needed to avoid missing a surgical facial fracture when only a CT of the head was obtained was 14.68.
CONCLUSIONS: The risks of missing a surgical facial fracture outweigh the monetary, radiation, and patient-desired necessity benefits of only performing a CT of the head. A CT of the face should be included in the trauma workup for those over the age of 65 when facial fractures are suspected.