Craniomaxillofacial trauma
Epidemiology of Facial Fracture Injuries

https://doi.org/10.1016/j.joms.2011.02.057Get rights and content

Purpose

Injuries resulting from accidents are a leading cause of mortality and morbidity. The objective of this study was to present epidemiologic estimates of hospital-based emergency department (ED) visits for facial fractures in the United States.

Materials and Methods

The Nationwide Emergency Department Sample for 2007 was used. All ED visits with facial fractures were selected. Demographic characteristics of these ED visits, causes of injuries, presence of concomitant injuries, and resource use in hospitals were examined. All estimates were projected to national levels and each ED visit was the unit of analysis.

Results

During 2007 in the United States, 407,167 ED visits concerned a facial fracture. Patients' average age for each ED visit was 37.9 years. Sixty-eight percent of all ED visits concerned male patients, and 85,759 ED visits resulted in further treatment in the same hospital. Three hundred fourteen patients died in EDs, and 2,717 died during hospitalization. Mean charge per each ED visit was $3,192. Total United States ED charges were close to $1 billion. Mean hospitalization charges (ED and inpatient charges) amounted to $62,414. Mean length of stay was 6.23 days, and total hospitalization time in the entire United States was 534,322 days. Frequently reported causes of injuries included assaults (37% of all ED visits), falls (24.6%), and motor vehicle accidents (12.1%).

Conclusions

The management of maxillofacial fractures in EDs across the United States uses considerable resources. The public health impact of facial fractures is highlighted in the present study.

Section snippets

Description of Database

The Nationwide Emergency Department Sample (NEDS) for 2007, a database of the Healthcare Cost and Utilization Project (HCUP), was used for the current study.9 The HCUP is sponsored by the Agency for Healthcare Research and Quality (AHRQ). The NEDS database enables analyses of ED use patterns. The NEDS database is a 20% stratified sample of hospital-based ED visits in the United States and is the largest all-payer ED sample that is publicly available. The NEDS 2007 database draws its sample from

Results

In total 407,167 ED visits were reported to concern a facial fracture in the United States during 2007. The average age of a patient at each ED visit was 37.9 years. Close to 68% of all ED visits occurred in men and about 36% occurred during the weekends (Table 1). After an ED visit, 71% were discharged routinely, 3.5% to a short-term facility, 1.7% to another facility (including skilled nursing facility, intermediate care, and another type of facility), 0.5% to home health care, 0.5% were

Discussion

The present study used the largest all-payer, nationally representative, hospital-based ED database in the United States to describe the epidemiology of facial fractures in the United States. The present study showed that 26.4% of those who presented to an ED with facial fracture were uninsured and a further 28.7% had Medicaid or Medicare listed as their primary insurance. In fact, only 37.5% of those who presented with facial fractures had private health insurance. A 2009 U.S. Census Bureau

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