Lorenz F Jeffrey, Rothka Andrew J, Schopper Heather K, Lighthall Jessyka G
Department of Otolaryngology-Head and Neck Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA.
College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2025 Feb;172(2):444-456. doi: 10.1002/ohn.981. Epub 2024 Oct 1.
To compare the incidence, etiology, demographics, and treatment of craniomaxillofacial (CMF) trauma before, during, and after COVID-19.
Retrospective cohort.
Eighty-three health care organizations across the United States.
The TriNetX Research Network identified 77,977,880 patients during 2017 to 2022. CMF fractures and soft tissue injuries during March to August of each year, aligning with the 2020 pandemic lockdown, were analyzed.
In 2020, compared to immediately prepandemic in 2019, there were significant reductions of -17.5% in facial fractures and -19.0% in soft tissue injuries (P < .001). Conversely, in 2021, both injury types increased by +16.7% and +16.3%, respectively, compared to 2020 (P < .001). Changes in injury mechanisms in 2020 included significant decreases in athletic injuries (-57.6%), falls (-16.8%), assaults (-15.5%), motor vehicle collisions (-8.7%), and pedestrian accidents (-6.9%) (P < .01), while off-road vehicle (+48.4%), bicycle (+16.2%), and motorcycle (+8.9%) accidents increased (P < .01). The 10- to 14- and 5- to 9-year-old age groups experienced the most substantial reductions in facial fractures (-39.7% and -29.9%, respectively) and soft tissue injuries (-29.2% and -28.3%, respectively) in 2020 compared to 2019 (P < .001). Operative management of fractures and soft tissue injuries dropped by -20.3% and -12.4%, respectively, in 2020 versus 2019, and then rebounded with +15.8% and +14.6% increases in 2021 compared to 2020 (P < .001). In 2022, compared to prepandemic rates of 2019, there were fewer patients with facial fractures (-2.8%), soft tissue injuries (-4.5%), and operative repairs (-6.9% for fractures, -1.2% for soft tissue injuries) (P < .03).
CMF trauma decreased in 2020, with subsequent years showing a rebound to levels slightly below those immediately prior to pandemic onset. Changes in etiology, demographics, and treatment highlight the complex dynamics of traumatic injuries during periods of societal disruption.
比较2019冠状病毒病（COVID-19）之前、期间和之后颅颌面（CMF）创伤的发病率、病因、人口统计学特征及治疗情况。
回顾性队列研究。
美国83个医疗保健机构。
TriNetX研究网络在2017年至2022年期间识别出77,977,880例患者。对每年3月至8月期间发生的CMF骨折和软组织损伤进行分析，该时间段与2020年疫情封锁期一致。
2020年，与紧接疫情前的2019年相比，面部骨折显著减少了17.5%，软组织损伤显著减少了19.0%（P < 0.001）。相反，与2020年相比，2021年这两种损伤类型分别增加了16.7%和16.3%（P < 0.001）。2020年损伤机制的变化包括运动损伤（-57.6%）、跌倒（-16.8%）、袭击（-15.5%）、机动车碰撞（-8.7%）和行人事故（-6.9%）显著减少（P < 0.01），而越野车事故（+48.4%）、自行车事故（+16.2%）和摩托车事故（+8.9%）增加（P < 0.01）。与2019年相比，2020年10至14岁和5至9岁年龄组的面部骨折（分别为-39.7%和-29.9%）和软组织损伤（分别为-29.2%和-28.3%）减少最为显著（P < 0.001）。与2019年相比，2020年骨折和软组织损伤的手术治疗分别下降了20.3%和12.4%，然后与2020年相比，2021年分别反弹增加了15.8%和14.6%（P < 0.001）。与2019年疫情前的发病率相比，2022年面部骨折患者（-2.8%）、软组织损伤患者（-4.5%）和手术修复患者（骨折-6.9%，软组织损伤-1.2%）减少（P < 0.03）。
2020年CMF创伤有所减少，随后几年反弹至略低于疫情爆发前的水平。病因、人口统计学特征和治疗的变化突出了社会动荡时期创伤性损伤的复杂动态。
