al-Qurainy I A, Titterington D M, Dutton G N, Stassen L F, Moos K F, el-Attar A
Tennent Institute of Ophthalmology, Western Infirmary, Glasgow.
Br J Oral Maxillofac Surg. 1991 Dec;29(6):363-7. doi: 10.1016/0266-4356(91)90001-l.
Maxillofacial trauma is often complicated by injury to the eye. Such injuries may be difficult to detect and may therefore be missed. Detailed ophthalmic examinations were carried out prospectively on 363 patients who had sustained midfacial fractures. Fifty four parameters comprising maxillofacial, radiological and ophthalmic data were recorded and coded for each patient. All encoded data were divided into predictors (the data potentially available to the maxillofacial surgeon) and outcome (the data potentially available to the ophthalmologist). Statistical methods of regression, and the analysis of contingency tables, led to the identification of the principal predictors indicative of underlying ophthalmic injury and thence to a scoring system which predicts the severity of such injuries. Impaired visual acuity is the principal predictor and when employed alone gives a sensitivity value of 80%. Pure blow-out fracture or comminuted facial fracture, double vision and amnesia emerged as additional factors which yielded an efficient scoring system with a sensitivity of 89% and specificity of 90% for the population upon which it was based. A score sheet is provided in the paper. These predictors can be remembered from the acronym Blow-out fracture, Acuity, Diplopia, Amnesia, Comminuted Trauma. As many such injuries result from a BAD ACT, it is easily remembered. This scoring system requires to be tested upon a new population of individuals in order to determine its efficacy.
颌面创伤常因眼部受伤而变得复杂。此类损伤可能难以察觉，因而可能被漏诊。对363例发生面中部骨折的患者进行了前瞻性详细眼科检查。为每位患者记录并编码了包括颌面、放射学和眼科数据在内的54项参数。所有编码数据被分为预测指标（颌面外科医生可能获取的数据）和结果指标（眼科医生可能获取的数据）。通过回归统计方法和列联表分析，确定了表明潜在眼部损伤的主要预测指标，并由此得出一个预测此类损伤严重程度的评分系统。视力受损是主要预测指标，单独使用时灵敏度值为80%。单纯性爆裂骨折或粉碎性面部骨折、复视和失忆是另外的因素，由此产生了一个有效的评分系统，对其基于的人群而言，灵敏度为89%，特异度为90%。论文中提供了一份评分表。这些预测指标可通过首字母缩略词“爆裂骨折、视力、复视、失忆、粉碎性创伤”记住。由于许多此类损伤是由“不良行为（BAD ACT）”导致的，所以很容易记住。这个评分系统需要在新的人群中进行测试，以确定其有效性。
