Viewing abstract #1670

Socioeconomic and Racial Disparities in Pediatric Craniofacial Trauma

Yadira Villalvazo, MD, MS1 Anne Glenney, BS1 Joseph Mocharnuk, BS1 Zhazira Irgebary, BA1 Lucy Cheng, BA1 Meeti Mehta, BS1 Casey Zhang, BA1 Jesse A. Goldstein, MD1 Joseph E. Losee, MD1 1Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Department of Plastic Surgery, Pittsburgh, PA
University of Pittsburgh Department of Plastic Surgery
2023-02-09

Presenter: Yadira Villalvazo, MD, MS

Affidavit:
The work presented represents only the original work of the fellow.

Director Name: J. Peter Rubin

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

PURPOSE: Pediatric facial fractures are a common cause of emergency department visits and hospital admissions. However, little has been published on the social determinants of health for pediatric facial fractures. This study aims to investigate the influence socioeconomic, racial, and household disparities have on the management of pediatric patients who present with facial trauma.

METHODS: A retrospective review was performed of patients under age 18 who were evaluated for facial fractures at a pediatric level I trauma center between 2006-2021. Variables studied included demographic information, CDC's Social Vulnerability Index (SVI), injury characteristics, management, and outcomes.

RESULTS: Facial fractures were diagnosed in 3334 patients; 2691 patients met inclusion criteria. A total of 18.3% were non- white, of whom 14.5% were Black. Black patients were 1.62 times more likely than white patients to present with mandibular fractures (p<0.001). Most fracture subtypes were associated with an increased SVI, unemployment, and a single parent household (p<0.0001). When controlling for fracture type, Black patients were 2.4 times more likely to receive imaging (p<0.0001) than white patients, but 0.52 times as likely to receive surgery (p<0.0001). Furthermore, Black patients were 2.2 times as likely to be uninsured as white patients (p=0.00021) and 1.5 times as likely to be lost to follow-up (p=0.00019).

CONCLUSION: Racial/ethnic minority status, lower socioeconomic status, and household characteristics, were all associated with certain fracture patterns and management pathways. Identifying systemic barriers that impact management and outcomes in vulnerable patients is necessary to overcome healthcare gaps and optimize clinical outcomes.