Department of Otolaryngology-Head and Neck Surgery at the Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, PA, USA.
Department of Otolaryngology - Head and Neck Surgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA.
Int J Pediatr Otorhinolaryngol. 2020 Dec;139:110428. doi: 10.1016/j.ijporl.2020.110428. Epub 2020 Oct 7.
To determine the incidence, demographics, and outcomes of concurrent cervical spine (C-spine) fractures in pediatric facial trauma.
The Kids' Inpatient Database (KID) from the 2016 Healthcare Cost Utilization Project (HCUP) was queried for various facial fractures using International Classification of Diseases Tenth Revision (ICD-10) diagnosis codes. Mandible fractures were further subdivided into fracture site. Patients aged 0-18 were included, and rates of C-spine fracture were analyzed with regards to demographic factors, length of stay, total charges, mortality rate, hospital characteristics, and concurrent facial fractures.
Of 5568 patients included, 4.18% presented with C-spine fracture. Children with C-spine fractures were significantly older (15.02 vs 12.76 years, p < 0.001) and length of stay was significantly longer (11.33 vs 6.44 days, p < 0.001). There was no difference in rate of C-spine fracture when stratified by gender, time of week/year, hospital location/type, or facial fracture other than subcondylar fractures. Subcondylar fractures were positively associated with C-spine fractures (OR 2.08, p = 0.002). C-spine fractures were associated with significantly higher mortality, length of stay, rate of tracheostomy, transfer out of index hospital, and total hospital charges.
A significant association exists between subcondylar mandible and C-spine fractures. Awareness of this information is vital for clinicians who manage pediatric facial trauma and alerts them to the need to rule out C-spine fractures in this group as these patients have significantly higher lengths of stay, total mean hospital costs, mortality and tracheostomy rates.
确定儿童面部创伤中并发颈椎（C 脊柱）骨折的发生率、人口统计学特征和结局。
使用国际疾病分类第十版（ICD-10）诊断代码，从 2016 年医疗保健成本利用项目（HCUP）的儿童住院数据库（KID）中查询各种面部骨折。将下颌骨骨折进一步细分为骨折部位。纳入年龄 0-18 岁的患者，并根据人口统计学因素、住院时间、总费用、死亡率、医院特征以及并发面部骨折分析 C 脊柱骨折的发生率。
在 5568 名患者中，有 4.18%的患者发生 C 脊柱骨折。C 脊柱骨折的儿童年龄明显较大（15.02 岁比 12.76 岁，p<0.001），住院时间明显更长（11.33 天比 6.44 天，p<0.001）。按性别、周/年时间、医院位置/类型或除髁突下骨折以外的其他面部骨折分层，C 脊柱骨折的发生率没有差异。髁突下骨折与 C 脊柱骨折呈正相关（OR 2.08，p=0.002）。C 脊柱骨折与死亡率、住院时间、气管切开术率、转出索引医院和总住院费用显著相关。
髁突下下颌骨和 C 脊柱骨折之间存在显著相关性。管理儿童面部创伤的临床医生必须了解这一信息，这提醒他们在这组患者中需要排除 C 脊柱骨折的可能性，因为这些患者的住院时间、总平均住院费用、死亡率和气管切开术率明显更高。
