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The Burden of Road Traffic Accidents on Facial Fractures: National Trends, Injury Patterns, and Disparities in 154,185 Patients
Carol Wang
*, Daniel Y. Kwon, Keisha Montalmant, Peter Shamamian, Alex J. Sarosi, Nargiz Seyidova, Olachi Oleru, Peter J. Taub
Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
BackgroundRoad traffic accidents (RTAs) are a common cause of facial fractures and the second leading cause of unintentional injury deaths in the United States. The present study is the first to utilize the Healthcare Cost and Utilization Project National Inpatient Sample to investigate national trends, injury patterns and disparities in facial fractures secondary to RTAs.
MethodsA retrospective analysis was conducted of patients with primary facial fractures secondary to RTAs using the 2018-2021 National Inpatient Sample database. Patients were stratified into a RTA and non-RTA group and characteristics were compared with Chi-square analysis, T-tests, and binary logistic regression.
ResultsIn total, 154,185 primary facial fractures were identified, of which 17% (n = 26,115) were associated with RTAs. The RTA group was younger (34% vs 24% < 25 years, P < 0.01), more frequently Hispanic (18% vs 15%, P < 0.01), and had median household incomes in the bottom 50th percentile (62% vs. 60%, P < 0.01). The most common fracture types were mandibular (23%), frontal (14%), and orbital fractures (14%). Of these facial fractures, 35% (n = 9090) were isolated while 65% (n = 17,025) occurred in combination with other facial fractures. The RTA group was 50% more likely to have multiple facial fractures (OR = 1.5, P < 0.01). The RTA group commonly involved car occupants (41%), followed by motorcycle riders (15%), pedestrians (11%), and bicycle riders (10%). The RTA group had a longer length of stay (5.3 vs 4.0 days, P < 0.01), admission charge ($127,932 vs. $79,414, P < 0.01), mortality rate (1.9% vs 1.4%, P < 0.01) than the non-RTA group.
ConclusionRTA patients are associated with higher costs and mortality than other etiologies of facial fractures, likely due to combination fractures and associated injuries. Younger, Hispanic, and lower-income groups are disproportionately affected. The present findings provide valuable insights for plastic surgeons, informing resource allocation and advocacy for their facial fracture patients.
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