Kilgarriff Saoirse, Barry Louise, Lee Francesca, Ogunbowale Akinsola, Gilbride Michael, Wilson Mark
Department of Oral & Maxillofacial Surgery, University Hospital Limerick, St. Nessan's Road, Dooradoyle, V94 F858, Limerick, Ireland.
Ir J Med Sci. 2025 May 26. doi: 10.1007/s11845-025-03964-x.
The primary objective of this study was to assess the potential association between social deprivation and maxillofacial trauma in Midwest Ireland.
A retrospective cohort study of patients undergoing surgical management of maxillofacial fractures, between January 2014 and December 2023, was undertaken. The Pobal 2022 Index utilises recent census data to determine relative deprivation of each electoral region. This database was utilised to assign patients a socioeconomic quartile ranging from Q1 (most deprived) to Q4 (most affluent) and a numerical Deprivation Index Score (DIS).
A total of 529 patients were included, of which nine had sustained repeated facial fractures during the predetermined period. The majority of patients were male (86.43%), with a median age was 26.5 (Inter Quartile Range 20 - 36). Whilst the relative frequency of facial fractures was unaffected by area-level deprivation, fracture aetiology varied considerably across the social gradient. The incidence of assault-related fractures was significantly greater in low-income settings (Q1 versus Q3 + Q4, 66.07% versus 40.32%, p = 0.00046). Conversely, sport-related injuries were significantly more prevalent amongst affluent communities (Q3 + Q4 versus Q1 + Q2, 28.06% versus 17.89%, p = 0.0049).
The increased incidence of assault-related fractures amongst deprived communities may be secondary to poor social cohesion and higher background levels of community violence. Furthermore, known risk factors for physical violence - namely drug and alcohol misuse - are more prevalent in low-income settings. Public policy should be directed at tackling endemic healthcare disparities that contribute to the unequal distribution of maxillofacial trauma.
本研究的主要目的是评估爱尔兰中西部地区社会剥夺与颌面创伤之间的潜在关联。
对2014年1月至2023年12月期间接受颌面骨折手术治疗的患者进行回顾性队列研究。2022年波巴尔指数利用最新的人口普查数据来确定每个选区的相对剥夺程度。该数据库用于为患者分配一个社会经济四分位数，范围从Q1（最贫困）到Q4（最富裕），以及一个数值剥夺指数得分（DIS）。
共纳入529例患者，其中9例在预定期间遭受了反复面部骨折。大多数患者为男性（86.43%），中位年龄为26.5岁（四分位间距20 - 36岁）。虽然面部骨折的相对频率不受地区层面剥夺的影响，但骨折病因在社会梯度上有很大差异。低收入环境中与袭击相关骨折的发生率显著更高（Q1与Q3 + Q4相比，66.07%对40.32%，p = 0.00046）。相反，与运动相关的损伤在富裕社区中明显更为普遍（Q3 + Q4与Q1 + Q2相比，28.06%对17.89%，p = 0.0049）。
贫困社区中与袭击相关骨折发生率的增加可能是由于社会凝聚力差和社区暴力背景水平较高所致。此外，已知的身体暴力风险因素——即药物和酒精滥用——在低收入环境中更为普遍。公共政策应针对解决导致颌面创伤不平等分布的地方性医疗保健差异。
