Evaluating Initial Hospital Care Factors Impacting Management of Nasal Bone Fractures in Trauma Patients

Nasal fractures are common and can result in negative psychological and physical sequelae if insufficiently addressed. This study explores factors associated with corrective nasal bone repositioning among hospitalized adult trauma patients using the American College of Surgeons Trauma Quality Improvement Program database (2017-2022). Among 266,768 patients with nasal bone fractures, 20,330 (7.62%) underwent repositioning. Reduced odds of repositioning were associated with increased age, male sex (OR = 0.93, CI: 0.89-0.96), Black race (OR = 0.68, CI: 0.64-0.71), significant comorbidities, private insurance (OR = 0.90, CI: 0.86-0.93), self-pay (OR = 0.72, CI: 0.68-0.76), care at a level III trauma center (OR = 0.26, CI: 0.23-0.30), non-profit center (OR = 0.89, 0.84-0.94), or government hospital (OR = 0.42, CI: 0.32-0.56). In contrast, interfacility transfer (OR = 1.09, CI: 1.05-1.13), greater injury severity score, and concomitant facial injuries were associated with increased odds of undergoing repositioning. This large retrospective cohort study identifies factors associated with undergoing corrective treatment for nasal bone fractures and highlights demographic and treatment location disparities, necessitating standardized care protocols.