Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany.
Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany.
Clin Oral Investig. 2020 Jan;24(1):503-513. doi: 10.1007/s00784-019-03024-6. Epub 2019 Aug 3.
It was the aim of the study to analyse the prevalence of maxillofacial trauma (MFT) in severely injured patients after road traffic accidence (RTA) and to investigate associated factors.
In a retrospective study, data from patients after RTA by the TraumaRegister DGU® from 1993 to 2014 were evaluated for demographical and injury characteristics. The predictor variable was mechanism of injury and the outcome variables were type of injury, severity and hospital resources utilization.
During the investigation period, n = 62,196 patients were enclosed with a prevalence of maxillofacial injuries of 20.3% (MFT positive). The injury severity score of MFT-positive patients was higher than in the MTF-negative subgroup (27 ± 12.8 vs. 23.0 ± 12.7). If MFT positive, 39.8% show minor, 37.1% moderate, 21.5% serious and 1.6% severe maxillofacial injuries. Injuries of the midface occurred in 60.3% of MTF-positive patients. A relevant blood loss (> 20% of total blood volume) occurred in 1.9%. MFT-positive patients had a higher coincidence with cervical spine fractures (11.3% vs. 7.8%) and traumatic brain injuries (62.6% vs. 34.8%) than MFT-negative patients. There was a noticeable decrease in the incidence of facial injuries in car/truck drivers during the study period.
Every 5th patient after RTA shows a MFT and the whole trauma team must be aware that this indicates a high prevalence of traumatic brain and cervical spine injuries.
Even if sole injuries of the face are seldom life threatening, maxillofacial expertise in interdisciplinary trauma centres is strongly recommended.
分析道路交通事故（RTA）后严重受伤患者的颌面外伤（MFT）发生率，并探讨相关因素。
本研究为回顾性研究，对 1993 年至 2014 年 TraumaRegister DGU®中 RTA 患者的数据进行了评估，以了解患者的人口统计学和损伤特征。预测变量为损伤机制，结局变量为损伤类型、严重程度和医院资源利用。
在研究期间，共纳入 62196 例患者，颌面损伤发生率为 20.3%（MFT 阳性）。MFT 阳性患者的损伤严重程度评分高于 MFT 阴性亚组（27±12.8 比 23.0±12.7）。如果 MFT 阳性，39.8%为轻度，37.1%为中度，21.5%为严重，1.6%为重度颌面损伤。60.3%的 MFT 阳性患者发生中面部损伤。1.9%的患者发生相关失血（>20%的总血容量）。MFT 阳性患者与颈椎骨折（11.3%比 7.8%）和创伤性脑损伤（62.6%比 34.8%）的合并率高于 MFT 阴性患者。在此研究期间，汽车/卡车司机面部损伤的发生率明显下降。
RTA 后每 5 例患者中就有 1 例发生 MFT，整个创伤团队必须意识到这表明存在较高的创伤性脑和颈椎损伤发生率。
即使单纯的面部损伤很少危及生命，但强烈建议在跨学科创伤中心配备颌面专业知识。
