Trends in Gender Authorship of Abstract Presentations at Plastic Surgery the Meeting: A Decade Long Analysis.

ABSTRACT: Current literature fails to examine gender differences of authors presenting abstracts at national plastic surgery meetings. This study aims to assess the ratio of female to male abstract presentations at Plastic Surgery The Meeting (PSTM).The gender of all abstract presenters from PSTM between 2010 and 2020 was recorded. The primary outcome variable was authorship (first, second, or last). Trends in gender authorship were assessed via Cochran-Armitage trend tests. Chi-square was utilized to evaluate the association between author gender and presentation type and author gender and subspecialty.Between 2010 and 2020, 3653 abstracts were presented (oral = 3035, 83.1%; poster = 618, 16.9%) with 19,328 (5175 females, 26.8%) authors. Of these, 34.5%, 32.0%, and 18.6% of first, second, and last authors were female, respectively. The total proportion of female authors increased from 153 (20.4%) in 2010 to 1065 (33.1%) by 2020. The proportion of female first, second, and last authors increased from 21.8% to 44.8%, 24.0% to 45.3%, and 14.3% to 22.1%, respectively, and demonstrated a positive linear trend ( P < 0.001 ). The proportion of female first authors in aesthetics (23.9%) was lower than that for breast (41.8%), cranio/maxillofacial/head & neck (38.5%), practice management (43.3%), and research/technology (39.4%) ( P < 0.001 ).Our study demonstrates a significant increase in female representation as first, second, and last authors in abstract presentations at PSTM within the last decade, although the absolute prevalence remains low.

Malar and maxillary fractures among pediatric patients and the risk factors for mortality.

BACKGROUND/AIMS: No studies have characterized the morbidity and mortality of maxillary & malar fractures on a national scale. The aim of this study was to examine the risk factors for mortality in pediatric patients who had sustained maxillary and malar fractures by using a national pediatric hospital inpatient care database. MATERIALS AND METHODS: This retrospective cohort study was conducted using the Kids' Inpatient Database (KID). The primary predictor variable was the cause of injury. The primary outcome variable was mortality rate. Additional predictor variables included age, gender, race, income, payer information, year and place of injury, number of facial fractures, concomitant facial fractures, other fractures of the body, and intracranial/internal organ injury. Univariate and multivariate regression models were performed to assess risk factors for mortality. Statistical significance was set to a p-value <.05. RESULTS: A total of 5859 patients met the inclusion criteria. The most common age group was 13-17 years of age (n = 3816, 65.1%). Motor vehicle accidents were the most common mechanism of injury (n = 2172, 37.1%). The presence of cranial vault (OR = 2.81, p = .017), skull base (OR = 2.72, p < .001), and vertebral column fractures (OR = 2.13, p = .016), as well as sub-arachnoid hemorrhage (OR = 4.75, p = .005), traumatic pneumothorax/hemothorax (OR = 2.16, p = .015), and heart/lung injury (OR = 3.37, p < .001) were each independently associated with increased odds of mortality. CONCLUSIONS: Patients in their late teens most commonly sustained malar and maxillary fractures, likely due to general trends in craniomaxillofacial development. The presence of other fractures located in close proximity to the mid-face increased the risk of mortality among pediatric patients with malar and maxillary fractures. This may be explained by the anatomical approximation of the mid-face to vital neurovascular structures of the head, which, when damaged, may prove fatal.

Does Alcohol Use Influence Hospitalization Outcomes in Adults Suffering Craniomaxillofacial Fractures From Street Fighting?

Study Design: This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the corresponding ICD-10 codes. Objective: To determine whether alcohol use (measured by blood alcohol content (BAC)) in patients sustaining maxillofacial trauma from hand-to-hand fighting influence hospitalization outcomes. Methods: The primary predictor variable was BAC stratified into six categories of increasing magnitude. The primary outcome variable was mean length of hospital stay (days). The secondary outcome variable was total hospital charges (US dollars). Results: Our final sample consisted of 3038 craniomaxillofacial fractures. Each additional year in age added +$545 in hospital charges (P < .01). Non-elective admissions added $14 210 in hospital charges (P < .05). Patients admitted in 2018 experienced approximately $7537 more in hospital charges (P < .01). Le Fort fractures (+$61 921; P < .01), mandible fractures (+$13 227, P < .01), and skull base fractures (+$22 170; P < .05) were all independently associated with increased hospital charges. Skull base fractures added +7.6 days to the hospital stay (P < .01) and each additional year in patient age added +.1 days to the length of the hospital stay (P < .01). Conclusions: BAC levels did not increase length of stay or hospitalization charges. Le Fort fractures, mandible fractures, and skull base fracture each independently increased hospital charges. This reflects the necessary care (ie, ICU) and treatment (ie, ORIF) of such fractures. Older adults and elderly patients are associated with increased length of stay and hospital charges-they are likely to struggle in navigating the healthcare system and face socioeconomic barriers to discharge.

Risk factors associated with infection in patients sustaining dog bites to the face.

PURPOSE: The purpose of this study is to identify which patient-level factors, if any, influence the risk of infection following dog bite wounds to the face. MATERIALS AND METHODS: This retrospective cohort study was conducted using the Kids' Inpatient Database (KID). The primary predictor variable was the type of facial injury. The primary outcome variable was the presence of facial infection. SPSS was used to perform statistical analyses and statistical significance was set at a P-value of < 0.05. RESULTS: Our final sample comprised a total of 4,420 patients who suffered dog bites to the face, of which 1,237 (28.0%) resulted in infection. Open wound (n = 4,176, 94.5%) was the most common facial injury, followed by bone fractures (n = 105, 2.4%). Relative to children 16-20 years old, children who were 0-5 years old were three times more likely to develop an infection (P < 0.01). Finally, open wounds (P < 0.01) were over seven times more likely to get infected relative to fractures. CONCLUSIONS: Young children, particularly those below the age of five, are vulnerable to dog bite wounds to the face. Open wounds posed the greatest risk of getting infected.

Trends in Female Representation at Plastic Surgery Meetings: A Move Toward Gender Equity at the Podium.

Anecdotally, female plastic surgeons are disproportionately underrepresented as speakers, moderators, and panelists at national and regional plastic surgery meetings. No studies have attempted to quantify female representation at Plastic Surgery The Meeting (PSTM). The objective of our study is to examine trends in female participation at PSTM. Names of participating plastic surgeons and their conference positions were obtained from PSTM meeting programs between 2015-2020. Conference positions included instructor, lead, lecturer, moderator, panelist, or other. Presentations were grouped as the following: conference/symposium; general session; instructional course; and lab. An automated gender assignment tool (gender-api.com) was used to determine the gender of participants. Descriptive statistics and trend analyses using Cochran-Armitage trend tests were performed. Between 2015-2020, 3,382 individuals (602 females, 17.8%) presented at PSTM in one of the instructional or moderating roles. Female presenters at PSTM increased from 60 (12.4%) in 2015, to 155 (26.5%) by 2020. The results for the proportion of females presenting in the general session and the instructional courses were statistically significant (p < .0001; p =.029), demonstrating a positive linear trend in the female proportions over the years. From 2015 to 2020, the proportions of females holding positions as moderators, panelists, and "other" increased significantly (p = .011; p = .011; p < .0001). Although female participation at PSTM has shown substantial growth over the last five years, there still exists a considerable gender imbalance. Notably, females were less likely to hold prominent positions, such as instructors, leads, or lecturers.