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阿巴拉契亚三州地区创伤性面部骨折的年龄相关模式:一项五年回顾性研究。

Age-Related Patterns of Traumatic Facial Fractures in the Appalachian Tri-state Area: A Five-Year Retrospective Study.

作者信息

Rahimpour Armein, Baxter Jacy, Giangrosso Gerard, Murphy Abigail, Bown Paul, Denning David A, Ray Peter, Rahman Barry

机构信息

General Surgery, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

Plastic and Reconstructive Surgery, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

出版信息

Cureus. 2024 Jun 10;16(6):e62090. doi: 10.7759/cureus.62090. eCollection 2024 Jun.

Abstract

Introduction Traumatic facial injuries, leading to facial fractures represent a significant subset of traumatic events, with age emerging as a crucial determinant influencing both their etiology and outcomes. Understanding the age-related patterns of traumatic facial fractures is essential for developing targeted prevention and management strategies. In this context, the Appalachian tri-state area stands as an underexplored region concerning this issue, necessitating comprehensive research to elucidate the nuances of age-related traumatic facial fractures within this geographic context. Methods This retrospective study delves into the age-related patterns of traumatic facial fractures within the Appalachian tri-state area, drawing upon patient records from Cabell Huntington Hospital and Saint Mary's Medical Center spanning a five-year period. The study cohort encompasses 623 patients categorized into three age groups: individuals aged <22 years, those aged 22-65 years, and individuals over 65 years. Data analysis involves meticulous examination of mechanisms of injury, injury severity scores (ISSs), hospital length of stay, and the prevalence of surgical interventions across different age cohorts. Results Out of 623 patients, 104 (16.7%) were under 22 years old, 367 (58.9%) were between 22 and 65 years old, and 152 (24.4%) were over 65 years old. The majority were male (70%). Falls were the most common cause of facial fractures in patients over 65 (78%), while assaults were predominant in the 22-65 age group (24%), and motor vehicle collisions (MCVs) in those under 22 (34%). The median ISS and hospital stay durations were similar across age groups. 28% of patients underwent surgery, with significant variation among age groups (p<0.001): 38% for <22 years, 33% for 22-65 years, and 11% for >65 years. Mandibular fractures were more prevalent in younger patients, with rates of 12% for <22 years compared to 5.3% for >65 years. Logistic regression analysis revealed that patients aged 22-65 had 4.10 times higher odds (95% CI=2.38, 7.45, p<0.001) of undergoing surgery, while those under 22 had 5.14 times higher odds (95% CI=2.73, 10.0, p<0.001) compared to those over 65. Significant associations were found for mandibular and bilateral mandibular outcomes in patients aged 22-65 years. Discussion These findings underscore the imperative for tailored prevention strategies and age-specific treatment protocols to optimize patient outcomes. Fall prevention initiatives for the elderly and interventions addressing sports-related injuries for younger individuals are paramount. Moreover, the study highlights the necessity of specialized care protocols for elderly patients to minimize hospital stay durations and manage age-related comorbidities effectively. Moving forward, further research should address limitations, validate findings, and explore the efficacy of specific interventions, thereby paving the way for enhanced preventive measures and management strategies tailored to the diverse age cohorts affected by traumatic facial fractures in the Appalachian region.

摘要

引言 导致面部骨折的创伤性面部损伤是创伤事件中的一个重要子集,年龄是影响其病因和结果的关键决定因素。了解创伤性面部骨折的年龄相关模式对于制定有针对性的预防和管理策略至关重要。在此背景下,阿巴拉契亚三州地区在这个问题上是一个未被充分探索的地区,需要进行全面研究以阐明该地理背景下年龄相关创伤性面部骨折的细微差别。

方法 这项回顾性研究深入探讨了阿巴拉契亚三州地区创伤性面部骨折的年龄相关模式,利用了卡贝尔·亨廷顿医院和圣玛丽医疗中心五年期间的患者记录。研究队列包括623名患者,分为三个年龄组:年龄小于22岁的个体、年龄在22 - 65岁之间的个体以及年龄超过65岁的个体。数据分析包括对损伤机制、损伤严重程度评分(ISS)、住院时间以及不同年龄队列中手术干预发生率的细致检查。

结果 在623名患者中,104名(16.7%)年龄小于22岁,367名(58.9%)年龄在22至65岁之间,152名(24.4%)年龄超过65岁。大多数为男性(70%)。跌倒 是65岁以上患者面部骨折最常见的原因(78%),而在22 - 65岁年龄组中攻击伤占主导(24%),在22岁以下人群中机动车碰撞(MCV)是主要原因(34%)。各年龄组的ISS中位数和住院时间相似。28%的患者接受了手术,各年龄组之间存在显著差异(p<0.001):小于22岁的患者为38%,22 - 65岁的患者为33%,大于65岁的患者为11%。下颌骨骨折在年轻患者中更为普遍,小于22岁的患者发生率为12%,而大于65岁的患者为5.3%。逻辑回归分析显示,22 - 65岁的患者接受手术的几率比65岁以上的患者高4.10倍(95%CI = 2.38, 7.45, p<0.001),而小于22岁的患者比65岁以上的患者高5.14倍(95%CI = 2.73, 10.0, p<0.001)。在22 - 65岁的患者中,下颌骨和双侧下颌骨结果存在显著关联。

讨论 这些发现强调了制定量身定制的预防策略和针对特定年龄的治疗方案以优化患者结果的紧迫性。针对老年人的预防跌倒举措以及针对年轻人与运动相关损伤的干预措施至关重要。此外,该研究强调了为老年患者制定专门护理方案的必要性,以尽量缩短住院时间并有效管理与年龄相关的合并症。展望未来,进一步的研究应解决局限性、验证研究结果并探索特定干预措施的效果,从而为阿巴拉契亚地区受创伤性面部骨折影响的不同年龄队列制定强化预防措施和管理策略铺平道路。

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