Traumatic Brain Injury in Trauma Patients With Isolated Facial Fractures.

Area of Science:

• Trauma Surgery
• Neurology
• Emergency Medicine

Background:

• Diagnosing traumatic brain injury (TBI), especially mild TBI (mTBI), presents challenges, potentially delaying critical early intervention.
• Facial fractures can serve as objective indicators of force transmission to the brain.
• This study aimed to determine the prevalence of TBI in trauma patients with isolated facial fractures, stratified by injury severity.

Purpose of the Study:

• To characterize the prevalence of TBI in trauma patients with isolated facial fractures.
• To stratify TBI prevalence by facial fracture type and injury severity.
• To evaluate the utility of facial fractures as potential clinical markers for TBI.

Main Methods:

• Retrospective cross-sectional study utilizing the National Trauma Databank (NTDB) from 2007 to 2014.
• Analysis of 1,867,761 TBI patients, with 306,785 having isolated facial fractures identified via ICD-9 codes.
• Logistic regression was used to assess the odds of mTBI and moderate-to-severe TBI in relation to specific facial fractures, adjusted for injury severity.

Main Results:

• Patients with isolated facial fractures showed a concomitant mTBI prevalence of 21.3%–46.0% and moderate-to-severe TBI prevalence of 7.3%–18.4%.
• Mandibular fractures were associated with the lowest odds of both mTBI and moderate-to-severe TBI.
• Alveolar and palate fractures exhibited the highest odds of mTBI (OR 3.20) and moderate-to-severe TBI (OR 3.83).

Conclusions:

• Isolated facial fractures are highly prevalent across all TBI severity levels.
• Facial fractures can serve as valuable clinical markers for TBI in trauma patients.
• Identifying facial fractures can enhance awareness and facilitate early TBI intervention within existing trauma protocols.