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Psychiatric Comorbidities in a Large, Single Institution Database of Pediatric Facial Fractures
Joseph W. Mocharnuk, BA, Anne Glenney, BA, Zhazira Irgebay, BA, Sayna Matinrazm, BA, Jesse A. Goldstein, MD
University of Pittsburgh School of Medicine
2023-02-10
Presenter: Joseph Mocharnuk
Affidavit:
This abstract represents the work of the submitting author and his collaborating team.
Director Name: Vu Nguyen, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background
In pediatric trauma patients, psychiatric disorders are associated with increased length of stay, higher hospital charges, and a greater risk for mortality. The lack of resources to adequately diagnose and treat psychiatric conditions in trauma centers creates further care gaps for this population.
Methods
A retrospective review was performed of 3,334 facial fractures patients <18 years of age evaluated at a pediatric level I trauma center between 2006 and 2021. Patient psychiatric conditions included previously diagnosed ADHD, oppositional defiant disorder (ODD), depression, and bipolar disorder. Using chi-squared and independent sample t-tests, patients with a psychiatric history were compared with the rest of the cohort.
Results
One hundred ninety-eight patients (6%) had prior diagnoses of ADHD, 20 had ODD (1%), 36 had depression (1%) and 19 had bipolar disorder (1%). Mean age for patients with each psychiatric condition was greater than the rest of the cohort (p<0.001). Violence was the primary cause of injury in each psychiatric condition (ADHD 30% vs 10%, p<0.001; ODD 30% vs 12%, p=0.191; depression 53% vs 11%, p<0.001; bipolar disorder 31% vs 11%, p=0.069), whereas sports-related injuries were more common in the remainder of the cohort. Patients with a psychiatric condition were consistently more likely to be admitted, yet less likely to be surgically treated.
Conclusion
Our results highlight the impact of psychiatric conditions on pediatric facial fracture management and outcomes. This overlooked entity, seen more frequently with older children, is associated with violent and severe injuries that require more hospitalization but less surgical intervention.
