Hwang Kun, Huan Fan, Hwang Pil Joong
Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea.
J Craniofac Surg. 2013 May;24(3):909-13. doi: 10.1097/SCS.0b013e318287d0b9.
In this study, we attempted to compare facial trauma of late-middle-age patients (55-64 years, LM group) and old-age patients (>65 years old, OL group). The goal of this study was to evaluate the natural history of facial trauma in geriatric patients.The medical record of patients older than 55 years seeking treatment for facial trauma between March 2006 and February 2009 were reviewed, and parameters were collected. Seven hundred seventy-two patients (553 male, 219 female) were analyzed. There were 438 patients of the LM group (55-64 years old) and 334 patients of the OL group (>65 years old).In men (n = 553), the number of patients within the LM group (n = 336, 60.8%) was greater than the number in the OL group (n = 217, 39.2%). Of the 219 women, the number within the OL group (n = 117, 53.4%) was greater than that within the LM group (n = 102, 46.6%) (P = 0.000, χ). Facial lacerations comprised a significantly higher proportion in the OL group (79.3%) than that in the ML group (70.1%), whereas facial bone fractures were more frequent in the ML group (29.9%) than in the OL group (20.7%), which was significant (P = 0.004, χ). Assault and automobile accidents were significantly more frequent in the ML group (n = 65 [15.1%] and n = 31 [7.2%], respectively) than the OL group (n = 20 [6.0%] and n = 11 [3.3%]), whereas falls and pedestrian accidents were more significantly frequent in the OL group (n = 30 [9.0%] and n = 23 [6.9%], respectively) than in the LM group (n = 30 [7.0%] and n = 19 [4.4%]) (P = 0.000, χ). During the hours of the day, between 4 to 6 PM and 6 to 8 PM, injuries occurred more frequently in the OL group (14.5% and 12.4%, respectively) than in the LM group (10.5% and 11.0%, respectively). At the times of 8 to 10 PM and 10 PM to midnight, however, injuries occurred more frequently in the LM group (17.1%, 12.1%, respectively) than in the OL group (12.1% and 8.2%, respectively) (P = 0.03, χ). Frequency of injuries at home within the OL group (n = 68, 22.2%) was significantly higher than within the LM group (n = 55, 14.4%) (P = 0.001, χ), whereas frequency of injuries at the workplace of the LM group (n = 47, 12.3%) was significantly higher than that of the OL group (n = 16, 5.2%) (P = 0.001, χ). Alcohol ingestion at the time of injury was significantly more frequent in the LM group (n = 146, 34.1%) than in the OL group (n = 57, 17.3%) (P = 0.000, χ). In regard to diabetes, the OL group (35.6%) showed a higher prevalence than that of the LM group (25.4%; odds ratio, 2.65).Prevention of injury is important for elderly patients. It is worthy of notice that more than one fourth (26.8%) were in a drunken state at the time of injury. There were no significant differences in the days of hospitalization or in the interval from injury to operation. However, there were significant differences in the place of the injuries, causes of injuries, and time of injuries, which is important in the prevention of injuries. Attention should be paid to assault and automobile accidents in the LM group and to falls and pedestrian injuries in the OL group. Thus, injury prevention should be prepared for differently for both LM and OL groups.
在本研究中,我们试图比较中老年患者(55 - 64岁,LM组)和老年患者(>65岁,OL组)的面部创伤情况。本研究的目的是评估老年患者面部创伤的自然病程。回顾了2006年3月至2009年2月期间因面部创伤寻求治疗的55岁以上患者的病历,并收集了相关参数。共分析了772例患者(男性553例,女性219例)。其中LM组(55 - 64岁)有438例患者,OL组(>65岁)有334例患者。在男性(n = 553)中,LM组患者数量(n = 336,60.8%)多于OL组(n = 217,39.2%)。在219名女性中,OL组患者数量(n = 117,53.4%)多于LM组(n = 102,46.6%)(P = 0.000,χ检验)。面部撕裂伤在OL组中的比例(79.3%)显著高于ML组(70.1%),而面部骨折在ML组(29.9%)中比OL组(20.7%)更常见,差异具有统计学意义(P = 0.004,χ检验)。袭击和汽车事故在ML组(分别为n = 65 [15.1%]和n = 31 [7.2%])中比OL组(分别为n = 20 [6.0%]和n = 11 [3.3%])明显更频繁,而跌倒和行人事故在OL组(分别为n = 30 [9.0%]和n = 23 [6.9%])中比LM组(分别为n = 30 [7.0%]和n = 19 [4.4%])更显著频繁(P = 0.000,χ检验)。在一天中的时间段方面,下午4点至6点和6点至8点期间,OL组受伤频率(分别为14.5%和12.4%)高于LM组(分别为10.5%和11.0%)。然而,在晚上8点至10点和晚上10点至午夜时段,LM组受伤频率(分别为17.1%,12.1%)高于OL组(分别为12.1%和8.2%)(P = 0.03,χ检验)。OL组在家中受伤的频率(n = 68,22.2%)显著高于LM组(n = 55,14.4%)(P = 0.001,χ检验),而LM组在工作场所受伤的频率(n = 47,12.3%)显著高于OL组(n = 16,5.2%)(P = 0.001,χ检验)。受伤时饮酒在LM组(n = 146,34.1%)中比OL组(n = 57,17.3%)明显更频繁(P = 0.000,χ检验)。关于糖尿病,OL组(35.6%)的患病率高于LM组(25.4%;优势比为2.65)。预防受伤对老年患者很重要。值得注意的是,超过四分之一(26.8%)的患者在受伤时处于醉酒状态。住院天数或受伤至手术的间隔时间没有显著差异。然而,受伤地点、受伤原因和受伤时间存在显著差异,这对预防受伤很重要。应关注LM组中的袭击和汽车事故以及OL组中的跌倒和行人受伤情况。因此,应为LM组和OL组分别制定不同的预防受伤措施。