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多中心前瞻性研究:道路交通伤所致颌面创伤——世界口腔颌面创伤项目。

A Multicentric Prospective Study on Maxillofacial Trauma Due to Road Traffic Accidents: The World Oral and Maxillofacial Trauma Project.

机构信息

Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy.

Department Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria.

出版信息

J Craniofac Surg. 2022 Jun 1;33(4):1057-1062. doi: 10.1097/SCS.0000000000008440. Epub 2021 Dec 16.

Abstract

The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide.Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis.Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P  < 0.001).This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.

摘要

本前瞻性多中心研究的目的是分析全球道路交通伤(RTA)导致的颌面骨折的流行病学、模式和处理方法。2019 年 9 月 30 日星期一至 2020 年 10 月 4 日星期日期间,14 个颌面外科病房收治了 1066 例 RTA 相关骨折患者。分析了以下数据:年龄、性别、损伤机制、创伤时是否酗酒或吸毒、颌面骨折部位、面部损伤严重程度评分(FISS)、合并伤、创伤发生的日期和月份、治疗时间、治疗类型和住院时间。采用双变量和多变量统计分析对数据进行分析。870 例患者为男性,196 例为女性。最常见的损伤机制是摩托车事故(48%)。超过一半的患者有颌面骨中三分之一的骨折。研究样本中,59%的患者接受了切开复位内固定。有安全带和头盔的患者的中位面部损伤严重程度评分(3 分)和住院中位数(3 天)显著较低(P<0.001)。这项首次前瞻性、多中心的流行病学研究表明,摩托车事故是 RTA 相关骨折的主要原因,主要发生在年轻男性中。特别是在澳大利亚和欧洲,RTA 的发生率明显较低。此外,本研究发现,无安全装置的患者颌面损伤严重程度显著更高,住院时间更长,这表明道路安全政策在预防颌面损伤方面的有效性。

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