Mind the Difference: Characterizing the Impact of Behavioral Health Disorders on Facial Trauma

Area of Science:

• Trauma Surgery
• Plastic Surgery
• Psychiatry

Background:

• Patients with psychiatric diagnoses face elevated risks of traumatic injury.
• Premorbid behavioral health disorders (BHDs) can complicate craniofacial trauma, yet this is understudied.
• This study characterizes patients with premorbid BHDs who sustain facial fractures.

Purpose of the Study:

• To describe the characteristics and outcomes of patients with premorbid BHDs and facial fractures.
• To compare injury mechanisms, fracture patterns, and in-hospital outcomes between patients with and without BHDs.
• To identify factors predicting complications in craniofacial trauma patients with BHDs.

Main Methods:

• Analysis of adult patients with facial fractures from the 2013-2016 Trauma Quality Improvement Program datasets.
• Comparison of demographics, injury characteristics, fracture patterns, and in-hospital outcomes between patients with and without premorbid BHDs.
• Definition of BHDs to include major psychiatric illnesses, substance use disorders, ADHD, and dementia.

Main Results:

• 25% of facial fracture patients (240,104 total) had at least one premorbid BHD.
• Assault, self-inflicted injury, and multiple facial fractures were more common in the BHD group.
• The BHD group had significantly higher rates of pneumonia, substance withdrawal, unplanned intubation, and ICU admission.

Conclusions:

• Patients with BHD represent a distinct subset of facial trauma with different injury patterns and health statuses.
• Premorbid BHDs are linked to increased in-hospital complications and resource utilization.
• Understanding the interplay between craniofacial trauma and BHDs can improve patient outcomes and resource management.