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A Demographic Analysis of Craniomaxillofacial Trauma in the Era of COVID-19

Robert C. Clark, BS; Vikas S. Kotha, MD; Bijal Desai, BS; Edward H. Davidson, MD
Case Western Reserve University School of Medicine - University Hospitals Department of Plastic and
2021-02-01

Presenter: Robert Clark

Affidavit:
100% of the work in this project is the original work of the presenting medical student and his cited colleagues.

Director Name: Edward Davidson

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

BACKGROUND:
Challenges of COVID-19 could magnify the vulnerability of lower socioeconomic populations for craniomaxillofacial trauma (CMFT). This study compares regional CMFT presentations during the COVID-19 lockdown with those in 2019. We hypothesized that these unprecedented societal circumstances would correlate with disproportionately more CMF fractures in vulnerable populations.

METHODS:
An IRB approved retrospective review of CMFT presentations from 03/03-07/25 of 2019 (pre-pandemic cohort) and 2020 (pandemic cohort) was performed. Demographics, place of injury, and mechanism of injury (MOI) were collected. A poverty index was calculated based on residence utilizing census data. MOI was classified as violent or non-violent.

RESULTS:
Significant decrease in presentations was noted between pre-pandemic and pandemic cohorts (125 vs. 40 presentations). Difference between cohorts with respect to violent vs non-violent injury was insignificant (p=.706). There also was insignificant difference in age (p=.385), place of injury (p=.189), employment (p=.958), insurance (p=.636), marital status (p=.792), ethnicity (p=.097), and gender (p=.693).

Overall, there was significant correlation between greater poverty and violent MOI (p<.001). This held true in 2019 (p=.001) but was insignificant in 2020 (p=.108). Non-white ethnicity was associated with greater poverty in pre-pandemic (p<.001) and pandemic (p=.047) cohorts as well as with greater incidence of violent MOI in both cohorts (2019; p<.001, 2020; p=.032).

CONCLUSIONS:
Analysis indicates that the COVID-19 pandemic did not magnify CMFT in vulnerable populations. There was reduction in CMFT presentations without notable alteration of demographics or MOI. This may highlight newfound reluctance to access care or indicate reduced incidence associated with quarantine measures.

Author Contact Information:
Robert Clark
2183 North Saint James Parkway
Cleveland Heights, OH
44106

6197560597
6197560597 (cell)

Ohio,Pennsylvania,West Virginia,Indiana,Kentucky,Pennsylvania American Society of Plastic Surgeons

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