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Characteristics of facial fractures in pediatric ICU patients
Zhazira Irgebay, BA; Jesse A. Goldstein, MD; Joseph E. Losee, MD
University of Pittsburgh Medical Center
2022-01-26
Presenter: Zhazira Irgebay
Affidavit:
This student was responsible for over half of the conception, design, data collection, analysis of data, and abstract drafting for this project.
Director Name: Vu T Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Treatment of facial fractures in patients in the intensive care unit (ICU) have not been well categorized. The purpose of this study is to evaluate the management of pediatric facial fractures in patients in the ICU.
Methods: We performed a retrospective review of patients under 18 years old, who presented to a level I trauma center with facial fractures between 2005 to 2021. We evaluated types of facial fractures, mechanisms of injury, operative treatment, lowest GCS score, associated injuries in ICU patients.
Results: Facial fractures were diagnosed in 3334 patients. Two hundred and five patients met the inclusion criteria (6.1%). Average age was 9.7 +/- 4.9. Average length of stay was 9.2 +/- 10.9 days and average lowest GCS score was 10.3 +/- 4.6. Patients admitted to the ICU were more most commonly due to motor vehicle accidents (n = 122, 59.5%). Patients admitted to the ICU were significantly more likely to present with skull (n = 124, 60.5%, p<0.001), orbital (n = 140, 68.3%, p<0.001), and maxillary fractures (n = 96, 46.8%, p<0.001) and significantly less likely to present with mandibular fractures (n = 47, 22.9%, p = 0.020). ICU patients had significantly more neurological injuries (91.2% vs. 47.8%, p<0.001). ICU patients were less likely to undergo operative treatment compared to non-ICU admitted patients (OR, 0.7 [95% CI, 0.5-1.0]).
Conclusions: Pediatric facial fracture patients requiring intensive care have different etiology than those treated on the floors and their complex hospital course requires unique attention and management.
