Maxillofacial Surgery Unit, Emergency Department, ASST-GOM Niguarda, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
Department of Medical Physics, ASST-Monza, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy.
J Craniomaxillofac Surg. 2022 Feb;50(2):146-149. doi: 10.1016/j.jcms.2021.11.006. Epub 2021 Nov 15.
The study aims to assess the influence on mortality of motorcycle road accidents, caused by injuries to the head, chest, abdomen, face, skin, pelvis and extremities. Road motorcycle accidents consecutively admitted to Level I Trauma Center were retrospectively analyzed. Each body site involvement was classified through Abbreviated Injury Score (AIS-98), and Comprehensive Facial Injury (CFI) score; Injury Severity Score (ISS) was also calculated. The data collected were subjected to a descriptive analysis and inferential statistic, with uni- and multivariate analysis; mortality was the main outcome examined. 1862 patients were studied. Limbs (53.9%) and Head (53.8%) are the most involved body site, facial trauma regards 19.4% of the sample. Only 4.4% of Facial injuries occurred as isolated, 71.6% were associated to Head involvement. The overall mortality was 4.6% and 80.0% of dead patients were affected by Head injury. Multivariate analysis shows that head (OR=3.06, p <0.0001), thoracic (OR=1.82, p <0.0001) and abdominal trauma (OR=1.41, p =0.019) are predicting the risk of death. Facial trauma does not directly influence mortality and, however severe and distracting it may be, becomes secondary to the management of frequently associated brain injuries. Severity scores targeted to the risk of death, such as AIS and AIS-derived, are ineffective in describing the true characteristics of facial injuries. The CFI score has been shown to predict the weight of surgical treatment and the outcome of the hospital stay, therefore its use is recommended.
本研究旨在评估摩托车道路事故导致的头部、胸部、腹部、面部、皮肤、骨盆和四肢损伤对死亡率的影响。对连续收治于 I 级创伤中心的摩托车道路事故患者进行回顾性分析。通过简明损伤评分（AIS-98）和全面面部损伤（CFI）评分对每个身体部位的损伤进行分类；还计算了损伤严重程度评分（ISS）。收集的数据进行了描述性分析和推断统计，包括单变量和多变量分析；死亡率是主要的观察结果。共研究了 1862 例患者。四肢（53.9%）和头部（53.8%）是最常见的损伤部位，面部创伤占样本的 19.4%。只有 4.4%的面部损伤是孤立的，71.6%与头部损伤有关。总的死亡率为 4.6%，80.0%的死亡患者均有头部损伤。多变量分析显示，头部（OR=3.06，p<0.0001）、胸部（OR=1.82，p<0.0001）和腹部创伤（OR=1.41，p=0.019）是死亡风险的预测因素。面部创伤不会直接影响死亡率，而且无论其严重程度和对患者的影响程度如何，都将退居次要地位，需要优先处理经常伴发的脑损伤。针对死亡风险的严重程度评分，如 AIS 和 AIS 衍生评分，在描述面部损伤的真实特征方面效果不佳。CFI 评分已被证明可预测手术治疗的权重和住院治疗的结果，因此建议使用。
