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1.
J Stomatol Oral Maxillofac Surg ; : 101826, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38484842

RESUMO

OBJECTIVES: Altmetrics is one of the fields of bibliometrics that seeks to assess the impact and interest of a given subject through Internet users. The aim of this study is to make an altmetric analysis of the orthognathic surgery literature. METHODS: A literature search was conducted using Dimensions app up to December 2023. A list of the 100 most mentioned articles on the topic was compiled. A Google Trends search was performed with same strategy to visualize important data regarding internet search. Charts and tables were created using Microsoft Excel and VOSviewer software to allow bibliometric visualization. RESULTS: There was a very poor correlation between the number of mentions and the number of citations (r = 0.0202). Most articles discussed on technical innovations associated to orthognathic surgery, majority related to virtual planning (n = 26). Other topics considered interesting to internet readers were complications (n = 18), surgical technique (n = 14), and psychological aspects/quality of life (n = 13). CONCLUSION: Online interest in orthognathic surgery closely aligns with the level of academic interest but is also influenced by factors such as location and economic status. The internet is a powerful tool for disseminating scientific research to a broad audience, making it more accessible and engaging than traditional academic channels.

2.
J Stomatol Oral Maxillofac Surg ; 125(6): 101802, 2024 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-38369024

RESUMO

OBJECTIVE: This study aims to comprehensively analyze the global landscape of oral and maxillofacial surgery (OMFS) literature through bibliometrics. The research focuses on evaluating publication trends, influential topics, and the impact of scholarly works within the field. METHODS: Following the principles of the Leiden Manifesto, a literature search was conducted using the Web of Science database, encompassing seven OMFS journals. A total of 18,218 publications were analyzed, with indicators such as publication language, geographic location, specialty, year, citation, and authorship examined. Statistical analyses, including Pearson correlation tests and angular coefficient calculations, were performed in RStudio. RESULTS: The study revealed a strong upward trend in publications related to orthognathic surgery, trauma, and infections. Geographic analysis indicated a dominance of European and Asian contributions, with the USA leading in overall publications. The impact of self-citations was explored, emphasizing nuanced perspectives on their role in scholarly impact metrics. The data provided insights into the scholarly impact of OMFS publications, including the H-index, number of citations, and citing articles. CONCLUSION: The findings underscored potential global discrepancies in OMFS research, both geographically and in terms of topics covered. The study discussed the influence of language and journal impact on citation counts, emphasizing the role of English publications. Specific topics, such as trauma and infections, exhibited high scholarly interest and citation rates. Recommendations were made to encourage submissions on specific topics, such as cosmetic surgery and pathology, to enhance the diversity of OMFS literature. The study aims to foster international collaboration and leverage bibliometrics for evidence-based decision-making, educational strategies, and advancements in the dynamic field of oral and maxillofacial surgery.

3.
Oral Maxillofac Surg ; 28(1): 323-330, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36828972

RESUMO

PURPOSE: The purpose of the following study was to explore the patient feedback on academic oral and maxillofacial surgeons (OMSs) practicing in the United States (US) using the physician rating website (PRW) Healthgrades.com. METHODS: We conducted a retrospective cohort study on academic OMSs in the US using data from Healthgrades.com. Predictor variables included OMS characteristics or rating characteristics. The primary outcome variable was overall rating. Linear regression was used to determine independent predictors of overall rating. RESULTS: The final study sample consisted of 309 academic OMSs (mean age, 56.4 years; males, 86.4%). Age group was significantly associated with overall rating (p = 0.034). Dual-degree OMSs had a higher mean overall rating than single-degree OMSs (4.26 vs. 3.98, p = 0.012). The number of ratings was also significantly associated with overall rating (p = 0.019). Upon controlling for all other variables, merely age group was independently associated with overall rating. Specifically, OMSs aged 41-55 years were associated with a higher overall rating (+0.96, p = 0.022) relative to OMSs aged >70 years. CONCLUSIONS: The OPRs on Healthgrades.com for academic OMSs within the US are generally positive. Age was the only independent predictor for overall rating - younger OMSs (aged 41-55 years) were independently associated with a higher overall rating relative to older OMSs (aged >70 years). The new generation of younger OMSs is likely to be aware of PRWs and their implications in the growing world of online exposure.


Assuntos
Cirurgiões Bucomaxilofaciais , Satisfação do Paciente , Masculino , Humanos , Estados Unidos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Estudos Retrospectivos
4.
J Stomatol Oral Maxillofac Surg ; 125(3): 101701, 2023 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-37979780

RESUMO

PURPOSE: This paper aims to provide a bibliometric analysis of the maxillofacial reconstruction literature over 40 years and to compare the data with previous studies. METHODS: A bibliographical search for oral and maxillofacial surgery literature in maxillofacial reconstruction was conducted on Wef of Science. A graphic representation of authorship and keywords was created with VOSviewer. Mendeley and Microsoft Excel were used for tabulation and data visualization. Some statistical tests were performed with a 95 % confidence interval, which was considered significant. RESULTS: A total of 7417 articles from specialized journals were included in the study. These articles received 138,493 citations from 63,390 other studies, with an average citation count of 18.67, and a very high H-index. A total of 2375 specific keywords were analyzed, covering a wide range of topics, with two noteworthy MeSH keywords that have recently gained prominence. A total of 33 journals were included in the study, with a mean Impact Factor of 2.404, indicating a relatively high influence in the subject area. CONCLUSION: The high h-index reflects abundant and high-quality literature on maxillofacial reconstruction, with the United States leading in publication quantity. Emerging topics in maxillofacial reconstruction were discussed. These areas shape the discipline, driving advancements and offering opportunities for researchers and clinicians to contribute to progress and improve patient outcomes.

5.
Artigo em Inglês | MEDLINE | ID: mdl-37230836

RESUMO

OBJECTIVE: The purpose of our study was to analyze what factors influence the cost of orthognathic surgery performed within the US. STUDY DESIGN: This retrospective cohort study was completed using the Kids' Inpatient Database (KID) from 2000 to 2012 on all patients aged 14 to 20 years who had undergone orthognathic surgery. The predictor variables included patient and hospitalization characteristics. The primary outcome variable was hospital charge ($). Multivariate linear regression was conducted to determine independent predictors for increased/decreased hospital charge. RESULTS: The final sample consisted of 14 191 patients (mean age, 17.4 ± 1.6 years; females, 59.2%). Each additional day in the hospital added $8123 in hospital charges (P < .01). Relative to mandibular osteotomy, maxillary osteotomy (+$5703, P < .01) and bimaxillary osteotomy (+$9419, P < .01) were each associated with increased hospital charges. Genioplasty (+$3499, P < .01), transfusion of packed cells (TPC) (+$11 719, P < .01), continuous invasive mechanical ventilation (CIMV) <96 hours (+$23 502, P < .01), and CIMV ≥96 hours (+$30 901, P < .01) were each associated with significantly increased hospital charges. Obstructive sleep apnea (OSA) added $6560 in hospital charges (P < .01). CONCLUSIONS: Maxillary osteotomy and bimaxillary surgery were each associated with significantly increased charges relative to mandibular osteotomy. Concomitant genioplasty, TPC, CIMV, and OSA each significantly increased the charges. Each additional day to the length of stay significantly increased the charges.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Apneia Obstrutiva do Sono , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Estudos Retrospectivos , Mentoplastia
7.
Artigo em Inglês | MEDLINE | ID: mdl-36529671

RESUMO

OBJECTIVE: Websites that maintain online physician ratings, such as Yelp.com, have been growing in popularity throughout the United States. The purpose of this study was to determine which factors increase the risk for very poor reviews (1 out of 5 stars) on Yelp.com for oral and maxillofacial surgeons (OMSs) in private practice. STUDY DESIGN: A retrospective cohort study was conducted using data on OMSs from Yelp.com. Predictor variables included clinician characteristics, practice characteristics, and review characteristics. The primary outcome variable was a very poor review. Logistic regression was used to determine risk factors for a very poor review. RESULTS: The final sample consisted of 3802 reviews. Relative to male clinicians, female clinicians were 2.7 times (P < .01) more likely to receive a very poor review. Clinicians who completed residency during the 1970s were over 4.5 times (P < .01) more likely to receive a very poor review relative to clinicians who completed residency during the 2010s. Relative to clinical reviews, nonclinical reviews were more likely (odds ratio = 2.6, P < .01) to be very poor and clinical and nonclinical reviews were less likely (odds ration = 0.5, P < .01) to be very poor. CONCLUSIONS: Nonclinical reviews were more likely to be very poor relative to clinical reviews. Several clinician factors, including female sex and completing OMS residency during the 1970s, were risk factors for receiving a very poor review.


Assuntos
Cirurgiões Bucomaxilofaciais , Satisfação do Paciente , Humanos , Masculino , Estados Unidos , Feminino , Estudos Retrospectivos , Prática Privada , Internet
8.
Artigo em Inglês | MEDLINE | ID: mdl-36244952

RESUMO

OBJECTIVES: Intimate partner violence (IPV) has been recognized as a preventable public health crisis for over 20 years. Craniomaxillofacial (CMF) injuries are exceedingly common among victims of IPV. The objective of this study was to determine whether assault due to IPV is different than other types of assault. STUDY DESIGN: A retrospective cohort study using data from the Nationwide Inpatient Sample data sets from 2016 to 2018. Additionally, the case control was matched for age, sex, and race for patients within the initial sample of assault patients (n = 52,632). RESULTS: Our final study sample consisted of 1,114 patients. Patients with IPV were less likely to have concussions (1.7 vs 3.6%; P < .01) and traumatic subarachnoid hemorrhages (2.1 vs 4.1%; P < .01), but more likely to have diffuse traumatic brain injuries (26.1 vs 18.7%; P < .01). Patients with IPV were less likely to have schizoaffective disorder (1.5 vs 2.8%; P < .05) but were more likely to have depressive episodes (19.8 vs 13.6%; P < .01), major depressive disorder (10.7 vs 5.3%; P < .01), and adjustment disorder (4.8 vs 2.2%; P < .01). CONCLUSIONS: We found that victims of IPV would be more likely to be female, delay care, have a mental health diagnosis, and present with worse intracranial injuries than other forms of assault. We hope our study informs and empowers maxillofacial surgeons to be a vigilant member of the interdisciplinary team.


Assuntos
Transtorno Depressivo Maior , Violência por Parceiro Íntimo , Cirurgiões , Humanos , Feminino , Masculino , Estudos Retrospectivos , Violência por Parceiro Íntimo/psicologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-36229364

RESUMO

OBJECTIVE: The purpose of the following study was to determine whether health insurance impacts the risk of suicidal ideation among patients with head and neck cancer (HNC). STUDY DESIGN: A retrospective cohort study was completed using the 2016 to 2018 National Inpatient Sample on adult patients (≥18 years) with HNC. The primary predictor was health insurance. The primary outcome was suicidal ideation. Multivariate logistic regression was employed to identify risk factors for the primary outcome variable. RESULTS: The final study sample consisted of 29 231 patients with HNC. Not controlling for confounders, being a Medicaid patient was a risk factor for suicidal ideation (odds ratio [OR] 2.44; P < .01). However, after controlling for confounders, Medicaid was no longer a risk factor or suicidal ideation (OR 1.52; P = .190). Patients with alcohol dependence/abuse (OR 2.94; P < .01) and depression (OR 8.30; P < .01) were each more likely to experience suicidal ideation. CONCLUSIONS: Medicaid insurance was not a risk factor for suicidal ideation in our study. Depression and alcohol dependence/abuse were each risk factors for suicidal ideation. Oral cancer and oropharyngeal cancer each decreased the risk for suicidal ideations.


Assuntos
Alcoolismo , Neoplasias de Cabeça e Pescoço , Humanos , Adulto , Ideação Suicida , Estudos Retrospectivos , Fatores de Risco , Seguro Saúde , Depressão/epidemiologia
10.
Head Neck ; 45(1): 135-146, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36256590

RESUMO

BACKGROUND: Authors compare use of propeller flaps versus skin grafts in defect coverage after fibula flap harvest. MATERIALS AND METHODS: Retrospective review of patients who received either PFPF or STSG. Primary predictor variable was technique, and secondary predictor variables were comorbidities. Primary outcome variable was flap/graft healing, and secondary outcome variables were cosmesis, adverse events, effect on activities of daily living (ADLs), pain, additional procedures, and cost. Statistical analysis performed via independent sample t tests, ANOVA, and χ2 tests. Logistic regression analysis was performed. RESULTS: Study sample was 50 patients. PFPFs showed higher rates of success, while STSG showed increased complications and adverse events. Pain and ADLs significantly affected in STSG group. Cosmesis was better in the PFPF group, and overall cost was significantly higher in STSG group. CONCLUSION: PFPFs show greater success rates, fewer complications, improved cosmesis, less pain, reduced cost compared to STSG for wound coverage after fibula flap harvest.


Assuntos
Retalhos de Tecido Biológico , Procedimentos de Cirurgia Plástica , Humanos , Transplante de Pele/métodos , Retalhos de Tecido Biológico/transplante , Atividades Cotidianas , Estudos Retrospectivos , Dor
11.
Head Neck Pathol ; 17(2): 562-570, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36480092

RESUMO

BACKGROUND: Sclerosing odontogenic carcinoma is an exceedingly rare gnathic malignancy first described by Koutlas et al. in 2008, and was only recently designated as a distinct pathologic entity by World Health Organization in the 2017 Classification of Head and Neck Tumors. To date, fewer than fifteen cases of this neoplasm have been reported in the English language literature. This tumor is characterized by thin cords, strands, and small nests of epithelium in a densely sclerotic stroma. In some tumor foci, the density of the stroma may be sufficient to compress the epithelial component beyond detection in the absence of immunohistochemistry, thus rendering this entity a particularly challenging diagnosis in small sample sizes. METHODS: A 55-year-old male presented with an asymptomatic lesion of posterior left maxilla. Cone beam computed tomography (CBCT) demonstrated a large, well-defined bony lesion with scalloped border, spanning from canine to first molar. External root resorption of the adjacent teeth was also noted. Microscopic examination of the biopsy specimen revealed an odontogenic tumor with features consistent with sclerosing odontogenic carcinoma. Immunohistochemical staining was performed to confirm the diagnosis. RESULTS: The tumor was positive for CK5/6, CK19, E-cadherin, p63 and negative for CK20 and CK7. CONCLUSION: Sclerosing odontogenic carcinoma is a rare, low-grade malignancy of odontogenic origin, which represents a diagnosis of exclusion in many cases. An immunohistochemical profile demonstrating positivity for markers including CK5/6, CK19, p63, and E-cadherin, in addition to a set of pertinent negative findings, can aid in the diagnosis of this tumor. This entity appears to lack metastatic potential despite its locally destructive behavior and a common histologic finding of perineural invasion.


Assuntos
Carcinoma , Neoplasias Bucais , Tumores Odontogênicos , Masculino , Humanos , Tumores Odontogênicos/patologia , Maxila/patologia , Neoplasias Bucais/patologia , Epitélio/patologia , Carcinoma/patologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-36549944

RESUMO

OBJECTIVE: The aim of this study was to evaluate and compare quality of life (QoL) parameters in patients with oral potential malignant disorders (OPMDs), namely, oral lichen planus (OLP) and oral epithelial dysplasia (OED). STUDY DESIGN: A cross-sectional study was completed at the oral maxillofacial surgery/oral medicine practices at University of Pennsylvania. Patients with clinical and histopathologic confirmation of OLP or OED from January to June 2021 were included in the study. The primary predictor variable was the OPMD type. The primary outcome variable was the score of 3 separate surveys: the Chronic Oral Mucosal Disease Questionnaire-26 (COMDQ-26), Oral Potential Malignant Disorder QoL Questionnaire (OPMDQoL), and Hospital Anxiety and Depression Scale. Multiple linear regression was used to determine independent predictors of increased/decreased questionnaire scores. RESULTS: The final study sample consisted of 100 patients:53 patients had OLP (53.0%), 39 patients had OED (39.0%), and 8 patients had OLP with OED (8.0%). Relative to OED, OLP added 15.7 points to the COMDQ-26 survey score (P < .001). Relative to OED, OLP added 8.9 points to the OPMDQoL survey score (P = .003). CONCLUSIONS: Oral lichen planus shows significantly poorer QoL specifically within the COMD-26 and OPMDQoL questionnaires, compared with OED. Additionally, patients with OPMDs aged 40 to 64 years were independently associated with higher COMD-26 scores compared with older patients (>65 years).


Assuntos
Líquen Plano Bucal , Doenças da Boca , Lesões Pré-Cancerosas , Humanos , Líquen Plano Bucal/patologia , Qualidade de Vida , Estudos Transversais , Hiperplasia
13.
Oral Maxillofac Surg ; 27(1): 79-87, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35088217

RESUMO

PURPOSE: The purpose of the present study is to determine whether handguns discharged at the craniomaxillofacial region are associated with greater fatality in suicide attempts relative to shotguns. METHODS: The following retrospective cohort study was completed using the Nationwide Inpatient Sample (NIS), a Healthcare Cost and Utilization Project (HCUP) database. The primary predictor variable was the type of firearm (handguns vs. shotguns). The primary outcome variable was prognosis (fatality vs. no fatality). A binary logistic regression was performed to determine the risk of mortality of all predictor variables. RESULTS: Our final sample consisted of 223 patients. Handguns (85.2%) were the most popular firearm. Relative to black patients, white patients were over three times more likely to die (p < 0.05). Compared to patients who were transferred in, patients not transferred in were eight times more likely to die (p = 0.000). Relative to patients who were admitted electively, patients who were not admitted electively were 16.7 times more likely to die (p < 0.01). Finally, relative to patients who used shotguns, patients who used handguns were 3.4 times more likely to die (p = 0.002). CONCLUSION: Self-inflicted gunshot wounds to the maxillofacial region by handguns were more lethal than shotguns.


Assuntos
Armas de Fogo , Ferimentos por Arma de Fogo , Humanos , Estudos Retrospectivos , Pacientes Internados
14.
Cleft Palate Craniofac J ; 60(8): 986-992, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-35306875

RESUMO

OBJECTIVE: To determine the risk factors and their respective magnitudes for developing Obstructive Sleep Apnea (OSA) in Down syndrome (DS) patients. DESIGN: Retrospective cohort study. PATIENTS: The 2016 Kids' Inpatient Database (KID) was queried to identify all patients diagnosed with DS. MAIN OUTCOME MEASURES: The primary predictor variables were tonsillar hypertrophy (TH), adenoidal hypertrophy (AH), Hypertrophy of Tonsils & Adenoids (HTA), Laryngeal Stenosis (LS), Hypotonia, Glossoptosis, Congenital Laryngomalacia (CL), and Overweight & Obesity (OO). The primary outcome variable was OSA. RESULTS: The final sample consisted of 18,181 patients with a diagnosis of DS. Relative to patients aged 0-5, patients aged 6-10 (OR 3.5, P < 0.01), 11-5 (OR 3.4, P < 0.01), and 16 & above (OR 3.6, P < 0.01) were each independently associated with increased odds of OSA. Further, TH (OR 23.2, P < 0.01), AH (OR 20.3, P < 0.01), HTA (OR 64.2, P < 0.01), glossoptosis (OR 5.0, P < 0.01), CL (OR 4.3, P < 0.01), and OO (OR 3.7, P < 0.01) were all independent risk factors for OSA. CONCLUSIONS: The presence of hypertrophied tonsils and adenoids together was the strongest risk factor for OSA. DS patients aged six and above were at risk for OSA development relative to younger patients. Patients with DS should be tested for OSA, which otherwise will deteriorate their existing comorbidities.


Assuntos
Síndrome de Down , Glossoptose , Apneia Obstrutiva do Sono , Humanos , Síndrome de Down/complicações , Síndrome de Down/epidemiologia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/etiologia , Fatores de Risco , Hipertrofia/complicações
15.
Oral Maxillofac Surg ; 27(2): 305-311, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35488948

RESUMO

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.


Assuntos
Mordeduras e Picadas , Traumatismos Faciais , Fraturas Ósseas , Animais , Cães , Mordeduras e Picadas/epidemiologia , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/etiologia , Fraturas Ósseas/complicações , Estudos Retrospectivos , Fatores de Risco , Humanos
17.
J Tissue Eng Regen Med ; 16(11): 1047-1057, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36112534

RESUMO

Several devices used to harvest stem/progenitor cells from bone marrow are available to clinicians. This study compared three devices measuring stem cell yields and correlating those yields to bone regeneration. A flexible forward aspirating system Marrow Marxman (MM), a straight needle aspirating on withdrawal system Marrow Cellutions (MC), and a straight needle aspirating on withdrawal and centrifuging the aspirate (BMAC) were compared in a side-to-side patient comparison, as well as tissue engineered bone grafts. The FlexMetric system (MM) produced greater CFU-f values compared to the straight needle (MC) Δ = 1083/ml, p < 0.001 and 1225/ml, p < 0.001 than the BMAC system. This increased stem/progenitor cell yield also translated into a greater radiographic bone density at 6 months Δ = 88.3 Hu, p ≤ 0.001 versus MC and Δ = 116.7, p < 0.001 versus BMAC at 6 months and Δ = 72.2, p < 0.001 and Δ = 93.3, p < 0.001 at 9 months respectively. The increased stem/progenitor cell yield of the MM system clinically translated into greater bone regeneration as measured by bone volume p < 0.014 and p < 0.001 respectively, trabecular thickness p < 0.007 and p < 0.002 respectively, and trabecular separation p = 0.011 and p < 0.001. A flexible bone marrow aspirator produces higher yields of stem/progenitor cells. Higher yields of stem/progenitor cells translate into greater bone regeneration in tissue engineering. Flexmetric technology produces better bone regeneration due to a forward aspiration concept reducing dilution from peripheral blood and its ability to target lining cells along the inner cortex. Centrifugation systems are not required in tissue engineering procedures involving stem/progenitor cells due to nonviability or functional loss from g-forces.


Assuntos
Células da Medula Óssea , Medula Óssea , Humanos , Contagem de Células , Células-Tronco , Centrifugação
18.
J Oral Maxillofac Surg ; 80(12): 1943-1951, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36174662

RESUMO

PURPOSE: Le Fort III fractures are the most severe subtype of the Le Fort fractures and are associated with adverse clinical outcomes. The purpose of this study was to identify risk factors for mortality among patients who suffer Le Fort III fractures. MATERIALS AND METHODS: A retrospective cohort study was completed using the 2016-2018 National Inpatient Sample. Patients with isolated Le Fort III fractures were selected. Patients who incurred bone fractures or organ injuries outside the head and neck were excluded. There were multiple, heterogenous predictor variables. The primary outcome variable was mortality. Relative risk was used to determine independent risk factors of mortality. Statistical significance was deemed for P values less than .05. RESULTS: The final sample consisted of 559 patients (mean age, 45.9 years) who suffered a Le Fort III fracture, of whom 15 patients (2.68%) died. Most patients were male (82.7%) middle-aged adults (42.9%) of White race (66.5%) within the lowest income quartile (31.7%) that lived in large metro areas (54.9%). Relative to males, females were nearly 62 times more likely to die (P < .01). Relative to privately insured subjects, uninsured subjects were 23 times (P < .05) more likely to die. Relative to weekday admissions, weekend admissions increased the risk of mortality by 8 times (P < .05). Cranial vault fractures (odds ratio, 7.24; P < .05) and upper cervical fractures (odds ratio, 63.27; P < .05) were risk factors for mortality. Relative to males, females were at an increased risk for mortality (relative risk [RR] 7.14, 95% confidence interval [CI] 2.60, 19.61). Skull base fracture (RR 2.99, 95 CI 1.04, 8.63), cranial vault fracture (RR 3.04, 95 CI 1.07, 8.65), subdural hemorrhage (RR 2.98, 95 CI 1.10, 8.05), subarachnoid hemorrhage (RR 6.73, 95 CI 2.34, 19.35), and injury of blood vessels at neck level (RR 13.24, 95 CI 2.46, 71.16) were each risk factors for mortality. CONCLUSIONS: Intracranial injury was not a risk factor for mortality. Instead, cranial vault fractures and skull base fractures increased the risk for mortality. In addition, uninsured patients and female patients were each at an increased risk for mortality.


Assuntos
Fraturas Múltiplas , Fraturas Maxilares , Fraturas Cranianas , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Fraturas Cranianas/cirurgia , Estudos Retrospectivos , Fraturas Maxilares/etiologia , Fraturas Múltiplas/complicações , Fatores de Risco
19.
J Oral Maxillofac Surg ; 80(10): 1655-1662, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35964697

RESUMO

PURPOSE: The geriatric population is a constantly growing population that is especially vulnerable to trauma. The primary purpose of this study was to determine what factors are associated with increased rates of hospital admission in geriatric patients who sustain craniomaxillofacial fractures secondary to falls. MATERIALS AND METHODS: This is a 5-year retrospective cross-sectional study that was conducted using the NEISS database. There were several, heterogenous predictor variables. The primary outcome variable was admission rate, which was used as a proxy to the severity of injury. Patient and injury characteristics were compared using chi-square and independent-sample t-tests. Binary logistic regression was conducted to determine the risk of hospital admission. RESULTS: The final sample included 2,879 cases in total. The mean age of the study sample was 78.8 years (SD, 8.6 years). Most patients were white (51.6%) females (64.2%) who were injured at their respective homes (58.7%). Relative to injuries that took place at a sports center, injuries that took place at the patient's home (OR, 2.52; P < .05) independently increased the risk for admission. Relative to maxilla fracture, orbital bone fracture (OR, 3.91; P < .05) was an independent risk factor for admission. Relative to lacerations, intracranial injuries (OR, 3.76; P < .01) increased the risk of admission. CONCLUSIONS: Craniomaxillofacial fractures that took place at the patients' home were at increased risk for admission. Orbital bone fractures and intracranial injuries were at increased risk for admission. From our, and other studies findings, screening and fall prevention interventions should be implemented amongst the geriatric population.


Assuntos
Traumatismos Craniocerebrais , Fraturas Ósseas , Fraturas Maxilares , Fraturas Orbitárias , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Fraturas Maxilares/epidemiologia , Estudos Retrospectivos
20.
J Oral Maxillofac Surg ; 80(10): 1633-1640, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35922011

RESUMO

PURPOSE: The purpose of the present study is to compare the characteristics of dog bite wounds to the face and that of the rest of the body among the pediatric population in the United States and to determine independent risk factors for dog bite wounds to the face. METHODS: A retrospective cohort study was conducted using the Kids' Inpatient Database. There were multiple, heterogenous predictor variables. The primary outcome variable was a facial dog bite. A multivariate logistic regression was employed to identify independent risk factors for the primary outcome variable. A P value less than .05 was the threshold for statistical significance. RESULTS: Our final sample consisted of 9,057 patients who suffered dog bite injuries, of which 2,913 (32.2%) occurred on the face. Relative to individuals aged 16-20 years, individuals aged 0-5 (odds ratio [OR] 5.7; confidence interval [CI] 4.0, 8.1), 6-10 (OR 3.8; CI 2.6, 5.5), and 11-15 years (OR 1.6; CI 1.1, 2.5) were all independently associated with increased odds of incurring a facial dog bite injury. Patients who were not admitted electively were 2.5 times (CI 1.4, 4.6) more likely to incur a facial dog bite injury relative to patients who were admitted electively. CONCLUSIONS: Young children (0-5 years) were at the greatest risk for facial dog bites relative to children aged 16-20 years. Dog bites that were admitted on emergency were more likely to occur on the face relative to those that were electively admitted to the hospital. To reduce the risk for facial dog bites and the host of chronic psychological ramifications that accompany them, established preventative strategies ought to be exercised.


Assuntos
Mordeduras e Picadas , Animais , Mordeduras e Picadas/epidemiologia , Pré-Escolar , Cães , Hospitalização , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Estudos Retrospectivos , Fatores de Risco
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