EPIDEMIOLOGY OF FACIAL INJURY IN BLUNT ASSAULT - DETERMINANTS OF INCIDENCE AND OUTCOME IN 802 PATIENTS

Background: Facial assault trauma has reached epidemic proportions. Wh ile the biomechanics of injury, methods of repair, and general demogra phy of blunt facial trauma are well known, statistical associations be tween epidemiological factors, incidence, and outcome are poorly under stood. Objectives: To provide a comprehensive epidemiological survey o f this patient population. To assess factors determining outcome and p attern of injury. Design: Retrospective review of 802 patients admitte d with blunt assault facial trauma. Statistical analysis of associatio ns between epidemiological factors, incidence, and outcome with X-2 te st, 2-tailed t test, and Fisher exact test. Setting: Urban university and county hospital. Results: Statistically significant associations a re demonstrated between gender and the context of assault, incidence o f armed assault, presence of fracture, and rate of intoxication at inj ury. Poor prognostic indicators for outcome include use of tobacco and presence of a mandible fracture. Open reduction and internal fixation were found to bear a higher complication rate only in mandible fractu res. Conclusions: While choice of treatment carries a statistically si gnificant association with outcome, social variables, including gender , tobacco use, intoxication, and low socioeconomic status, produce dra matic worsening of both injury incidence and outcome.