Factors Associated With Head and Neck Polytrauma Presentation and Admissions at Emergency Departments of Varying Sizes.
Journal
The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410
Informations de publication
Date de publication:
03 Jun 2024
03 Jun 2024
Historique:
received:
12
09
2023
accepted:
04
05
2024
medline:
3
6
2024
pubmed:
3
6
2024
entrez:
3
6
2024
Statut:
aheadofprint
Résumé
Timely diagnosis of acute head and neck polytrauma presenting to emergency departments (EDs) optimizes outcomes. Since ED capacity influences triage and admission, the authors utilized the National Electronic Injury Surveillance System database to understand how ED size and trauma characteristics affect head and neck polytrauma presentation and admissions. Demographics and injury characteristics from the National Electronic Injury Surveillance System database from 2018 to 2021 were analyzed to delineate factors contributing to polytrauma presence and admission through multivariable logistic regressions. The authors' 207,951-patient cohort was primarily females (48.6%), non-Hispanic (62.4%), and white (51.4%) people who averaged 57.2 years old. Nonspecific head injuries were predominant (59.7%), followed by facial trauma (22.6%) with rare substance involvement (alcohol, 6.3%; drugs, 4.1%) presenting to high-volume EDs (48.5%). Of the patients, 20% were admitted, whereas 31.1% sustained polytrauma. Substance use [alcohol, odds ratio (OR) = 4.44; drugs, OR = 2.90] increased polytrauma likelihood; neck (OR = 1.35), face (OR = 1.14), and eye (OR = 1.26) associated with polytrauma more than head injuries. Burns (OR = 1.38) increased polytrauma likelihood more than internal organ injuries. Black patients sustained higher polytrauma when presented to non-small EDs (OR = 1.41-1.90) than white patients showed to small EDs. Admissions were higher for males (OR = 1.51). Relative to small EDs, large EDs demonstrated a higher increase in admissions (OR = 2.42). Neck traumas were more likely admitted than head traumas (OR = 1.71). Fractures (OR = 2.21) and burns (OR = 2.71) demonstrated an increased admission likelihood than internal organ injuries. Polytrauma presence and admissions likelihood are site, injury, and substance dependent. Understanding the impact of factors influencing polytrauma presence or admission will enhance triage to optimize outcomes.
Identifiants
pubmed: 38830051
doi: 10.1097/SCS.0000000000010371
pii: 00001665-990000000-01667
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 by Mutaz B. Habal, MD.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Petrone P, Velaz-Pardo L, Gendy A, et al. Diagnosis, management and treatment of neck trauma. Cir Esp 2019;97:489–500
O’Brien PJ, Cox MW. A modern approach to cervical vascular trauma. Perspect Vasc Surg Endovasc Ther 2011;23:90–97
Su P, Paquet C, O’Dell K, et al. Trends in operative complex middle and upper maxillofacial trauma: a 17-year study. Laryngoscope 2021;131:1985–1989
Alvi A, Doherty T, Lewen G. Facial fractures and concomitant injuries in trauma patients. Laryngoscope 2003;113:102–106
Follmar KE, Debruijn M, Baccarani A, et al. Concomitant injuries in patients with panfacial fractures. J Trauma 2007;63:831–835
Streubel SO, Mirsky DM. Craniomaxillofacial trauma. Facial Plast Surg Clin North Am 2016;24:605–617
Dobitsch AA, Oleck NC, Liu FC, et al. Sports-related pediatric facial trauma: analysis of facial fracture pattern and concomitant injuries. Surg J (NY) 2019;5:e146–e149
Zhou HH, Liu Q, Yang RT, et al. Ocular trauma in patients with maxillofacial fractures. J Craniofac Surg 2014;25:519–523
He CH, Poulsen DM, Parsikia A, et al. Characteristics of ocular trauma in the United States. Arq Bras Oftalmol 2022;85:240–248
Mohammad NK, Al-Mahdi AH, Mohammed OM. Ophthalmic injuries related to maxillofacial trauma due to urban warfare. J Craniofac Surg 2018;29:1804–1808
Kruse C, Bruce JL, Bekker W, et al. The management of ocular and peri-ocular trauma needs to be co-ordinated according to ATLS principles and requires multi-disciplinary collaboration. Injury 2021;52:2606–2610
Osetinsky LM, Hamilton GS, Carlson ML. Sport injuries of the ear and temporal bone. Clin Sports Med 2017;36:315–335
Kelley BP, Downey CR, Stal S. Evaluation and reduction of nasal trauma. Semin Plast Surg 2010;24:339–347
Henry M, Hern HG. Traumatic injuries of the ear, nose and throat. Emerg Med Clin North Am 2019;37:131–136
Amrith S, Saw SM, Lim TC, et al. Ophthalmic involvement in cranio-facial trauma. J Craniomaxillofac Surg 2000;28:140–147
Jamal BT, Pfahler SM, Lane KA, et al. Ophthalmic injuries in patients with zygomaticomaxillary complex fractures requiring surgical repair. J Oral Maxillofac Surg 2009;67:986–989
Smith H, Peek-Asa C, Nesheim D, et al. Etiology, diagnosis, and characteristics of facial fracture at a midwestern level I trauma center. J Trauma Nurs 2012;19:57–65
Bullocks JM, Hsu PW, Izaddoost SA, et al. Plastic Surgery Emergencies Principles and Techniques. 2nd edn. Thieme; 2017
Mccarty JC, Herrera-Escobar JP, Gadkaree SK, et al. Long-term functional outcomes of trauma patients with facial injuries. J Craniofac Surg 2021;32:2584–2587
Marchini L, Allareddy V. Epidemiology of facial fractures among older adults: a retrospective analysis of a nationwide emergency department database. Dent Traumatol 2019;35:109–114
Cairns C, Kang K National Hospital Ambulatory Medical Care Survey : 2020 Emergency Department Summary Tables. 2020 Accessed May 24, 2024. https://www.cdc.gov/nchs/data/nhamcs/web_tables/2020-nhamcs-ed-web-tables-508.pdf
Mackenzie EJ, Hoyt DB, Sacra JC, et al. National inventory of hospital trauma centers. J Am Med Assoc 2003;289:1515–1522
Schroeder T The Neiss Sample (Design and Implemntation) 1997 to Present. 2001. Accessed May 24, 2024. https://www.cpsc.gov/s3fs-public/pdfs/blk_media_2001d011-6b6.pdf
National Center for Health Statistics. Health, United States, 2020-2021: Table EDAd . Emergency department visits within the past 12 months among adults aged 18 and over, by selected characteristics: United States, selected years 1997–2019. 2021 Accessed May 24, 2024. https://www.cdc.gov/nchs/data/hus/2020-2021/EdAd.pdf
Allareddy V, Allareddy V, Nalliah RP. Epidemiology of facial fracture injuries. J Oral Maxillofac Surg 2011;69:2613–2618
Marco CA, Bryant M, Landrum B, et al. Refusal of emergency medical care: an analysis of patients who left without being seen, eloped, and left against medical advice. Am J Emerg Med 2021;40:115–119
Pines JM, Hollander JE. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med 2008;51:1–5
Reznek MA, Murray E, Youngren MN, et al. Door-to-imaging time for acute stroke patients is adversely affected by emergency department crowding. Stroke 2017;48:49–54
Richardson DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust 2006;184:213–216
Peterson SM, Harbertson CA, Scheulen JJ, et al. Trends and characterization of academic emergency department patient visits: a five-year review. Acad Emerg Med 2019;26:410–419
Plawecki A, Bobian M, Kandinov A, et al. Recreational activity and facial trauma among older adults. JAMA Facial Plast Surg 2017;19:453–458
Febbo A, Hoffman GR. To what extent does illicit drug use predispose to facial injury? An institutional investigation for an emergent problem. Craniomaxillofac Trauma Reconstr 2021;14:11–15
Hanba C, Svider PF, Chen FS, et al. Race and sex differences in adult facial fracture risk. JAMA Facial Plast Surg 2016;48201:441–448
McCaig LF, Xu J, Niska RW. Estimates of Emergency Department Capacity: United States, 2007. National Center for Health Statistics. May.2009. Accessed May 24, 2024. https://www.cdc.gov/nchs/data/hestat/ed_capacity/ed_capacity.pdf
Semega J, Kollar M Income in the United States: 2021 Current Population Reports. 2022. https://www.census.gov/content/dam/Census/library/publications/2022/demo/p60-276.pdf
Simms MC, Fortuny K, Henderson E. Racial and Ethnic Disparities Among Low-Income Families. LIWF Fact Sheet, The Urban Institute; 2024. https://www.urban.org/sites/default/files/publication/32976/411936-racial-and-ethnic-disparities-among-low-income-families.pdf
Parker K, Horowitz J, Brown A, et al. What Unites, Urban, Suburban and Rural Communities. Vol 22; 2018. Accessed May 25, 2023. https://www.pewresearch.org/social-trends/2018/05/22/demographic-and-economic-trends-in-urban-suburban-and-rural-communities/
Weiss AJ, Reid LD, Barrett ML Overview of Emergency Department Visits Related to Injuries, by Cause of Injury, 2017. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality (US). 2020.
Hanchate AD, Dyer KS, Paasche-orlow MK, et al. Disparities in emergency department visits among collocated racial/ethnic Medicare enrollees. Ann Emerg Med 2012;73:225–235
Parast L, Mathews M, Martino S, et al. Racial/ethnic differences in emergency department utilization and experience. J Gen Intern Med 2021;37:49–56
Zhang X, Carabello M, Hill T, et al. Trends of racial/ethnic differences in emergency department care outcomes among adults in the United States from 2005 to 2016. Front Med (Lausanne) 2020;7:1–11
Ghafil C, Matsushima K, Ding L, et al. Trends in trauma admissions during the COVID-19 pandemic in Los Angeles County, California. JAMA Netw Open 2021;4:e211320
O’Meara C, Witherspoon R, Hapangama N, et al. Alcohol and interpersonal violence may increase the severity of facial fracture. Br J Oral Maxillofac Surg 2012;50:36–40
Othman S, Cohn JE, Toscano M, et al. Substance use and maxillofacial trauma: a comprehensive patient profile. J Oral Maxillofac Surg 2020;78:235–240
Porto GG, de Menezes LP, Cavalcante DKF, et al. Do type of helmet and alcohol use increase facial trauma severity? J Oral Maxillofac Surg 2020;78:797.e1–797.e8
Roque-Torres J, Ramírez-Martínez L, Ramos-Meléndez EO, et al. Trends and outcomes of trauma patients positive to marijuana and cocaine. Eur J Trauma Emerg Surg 2023;49:1969–1979
Stanisce L, Fisher AH, Choi BY, et al. How did the COVID-19 pandemic affect trends in facial trauma? Craniomaxillofac Trauma Reconstr 2022;15:132–138
Suen LW, Makam AN, Snyder HR, et al. National prevalence of alcohol and other substance use disorders among emergency department visits and hospitalizations: NHAMCS 2014–2018. J Gen Intern Med 2022;37:2420–2428
White AM, Slater ME, Ng G, et al. Trends in alcohol-related emergency department visits in the United States: results from the nationwide emergency department sample, 2006 to 2014. Alcohol Clin Exp Res 2018;42:352–359
Sorenson TJ, Rich MD, Hagstrom M, et al. Alcohol and drug use while cycling significantly increases the likelihood of facial fractures. J Craniofac Surg 2021;32:2087–2090
Chermack ST, Blow FC. Violence among individuals in substance abuse treatment: the role of alcohol and cocaine consumption. Drug Alcohol Depend 2002;66:29–37
Crane CA, Easton CJ, Devine S. The association between phencyclidine use and partner violence: an initial examination. J Addict Dis 2013;32:150–157
Miller NS, Gold MS, Mahler JC. Violent behaviors associated with cocaine use: possible pharmacological mechanisms. Int J Addict 1991;26:1077–1088
Dries DJ, Endorf FW. Dries DJ, Endorf FW. Inhalation injury: epidemiology, pathology, treatment strategies. Scand J Trauma Resusc Emerg Med.2013;21:31
Huang RY, Chen SJ, Hsiao YC, et al. Positive signs on physical examination are not always indications for endotracheal tube intubation in patients with facial burn. BMC Emerg Med 2022;22:36
Walker PF, Buehner MF, Wood LA, et al. Diagnosis and management of inhalation injury: an updated review. Crit Care 2015;19:351
Gillenwater J, Garner WL. Thermal, chemical, and electrical injuries. Grabb and Smith’s Plastic Surgery. 8th edn., Wolters Kluwer, Chapter 21;2019:422–448.
Berry J, Ashley J, Jeffery S. Ophthalmological evaluation of facial burns in a regional burns centre. Burns 2020;46:970–973
Bouguila J, Ho Quoc C, Viard R, et al. Nose burns: 4-dimensional analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2017;134:333–337
Heilbronn CM, Svider PF, Folbe AJ, et al. Burns in the head and neck: a national representative analysis of emergency department visits. Laryngoscope 2015;125:1573–1578
Sabapathy SR, Shanmugakrishnan RR, Ramkumar S, et al. Postburn reconstruction of the face and neck. Plast Reconstr Surg 2022;150:1326E–1339E
Bez M, Bez D, Mph MD, et al. Isolated Versus Non-isolated Traumatic Brain Injuries Identification and Decision Making: A Comparative Study. Isr Med Assoc J. 2022;24:574–578.
Cancelliere C, Coronado VG, Taylor CA, et al. Epidemiology of isolated versus nonisolated mild traumatic brain injury treated in emergency departments in the United States, 2006-2012: Sociodemographic characteristics. J Head Trauma Rehabil 2017;32:E37–E46
Hsia RY, Markowitz AJ, Lin F, et al. Ten-year trends in traumatic brain injury: a retrospective cohort study of California emergency department and hospital revisits and readmissions. BMJ Open 2018;8:e022297
Holly LT, Kelly DF, Counelis GJ, et al. Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics. J Neurosurg Spine 2002;96:285–201
Lafta G, Sbahi H. Factors associated with the severity of traumatic brain injury. Med Pharm Rep 2023;96:58–64
Lucke-Wold B, Pierre K, Aghili-Mehrizi S, et al. Facial fractures: independent prediction of neurosurgical intervention. Asian J Neurosurg 2022;17:017–022
Nawi MAA, Noor NFM, Shaari R, et al. The patterns of facial fractures in traumatic brain injury (TBI) patients using ordinal regression: a retrospective study of five years. AIMS Neurosci 2022;9:345–357
NEISS Coding Manual. 2019 Accessed May 24, 2024. https://www.cpsc.gov/s3fs-public/2019_NEISS_Coding_Manual.pdf
Sethi RKV, Kozin ED, Fagenholz PJ, et al. Epidemiological survey of head and neck injuries and trauma in the United States. Otolaryngol Head Neck Surg 2014;151:776–784
Komut S, Sönmez BM, Erenler AK, et al. Clinical and demograhical characteristics of patients with maxillofacial trauma in the emergency department. Open J Emerg Med 2019;07:28–39
Winstead ML, Clegg DJ, Heidel RE, et al. Fall-related facial trauma: a retrospective review of fracture patterns and medical comorbidity. J Oral Maxillofac Surg 2021;79:864–870
Yan M, Mullen B, Wagner LH, et al. Predictors of surgical versus medical management of eyes in the setting of orbital fracture at an academic level I trauma center. J Craniofac 2023;34:1444–1447
Hornor MA, Blank JJ, Hatchimonji JS, et al. Higher center volume is significantly associated with lower mortality in trauma patients with shock. Injury 2023;54:1400–1405
Feral-Pierssens AL, Morris J, Marquis M, et al. Safety assessment of a redirection program using an electronic application for low-acuity patients visiting an emergency department. BMC Emerg Med 2022;22:71
Pai DR, Pakdil F. Emergency departments: the gatekeepers of admissions in Pennsylvania’s rural hospitals. Am J Emerg Med 2022;57:138–148
Gonullu ME, Filinte GT, Cardak NGA, et al. The surgical strategy for the intraorbital foreign bodies. J Craniofac Surg 2016;27:1785–1788
Shuker ST. Expanding hematoma’s life-threatening neck and face emergency management of ballistic injuries. J Craniofac Surg 2016;27:1282–1285
Choi KJ, Kahmke RR, Crowson MG, et al. Trends in otolaryngology consultation patterns at an academic quaternary care center. JAMA Otolaryngol Head Neck Surg 2017;143:472–477
Yiadom MYAB, Baugh CW, Barrett TW, et al. Measuring emergency department acuity. Acad Emerg Med 2018;25:65–75
DiMaggio CJ, Avraham JB, Lee DC, et al. The epidemiology of emergency department trauma discharges in the United States. Acad Emerg Med 2017;24:1244–1256
Demetriades D, Martin M, Salim A, et al. The effect of trauma center designation and trauma volume on outcome in specific severe injuries. Ann Surg 2005;242:512–517