Ievgen Shumynskyi1, Vitaliy Gurianov2, Oleksandr Kaniura3, Andrey Kopchak4. 1. Department of Dentistry, Institute of Postgraduate Education, O. Bogomolets National Medical University, 34, Peremohy Avenue, the 2nd floor of the "physical-chemical" building, Kyiv, Ukraine. shuminsky@icloud.com. 2. Health Management Department, O. Bogomolets National Medical University, 13, T. Shevchenko Blvd., Kyiv, 01601, Ukraine. 3. Department of Orthodontics and Prosthetic Dentistry, O. Bogomolets National Medical University, 13, T. Shevchenko Blvd., Kyiv, 01601, Ukraine. 4. Department of Dentistry, Institute of Postgraduate Education, O. Bogomolets National Medical University, 34, Peremohy Avenue, the 2nd floor of the "physical-chemical" building, Kyiv, Ukraine.
Abstract
PURPOSE: Identify the most common concomitant injuries associated with facial trauma, and compare the efficacy of various scoring systems in estimation of mortality risks in this category of patients. METHODS: The study evaluated patients with facial and concomitant injuries, who received the multidisciplinary treatment in a specialized trauma hospital. Values of New Injury Severity Score, Glasgow Coma Scale, Facial Injury Severity Scale, age, and length of hospital stay were statistically analysed to determine presence of relationships between these indicators and define factors that significantly associated with lethal outcome. RESULTS: During 6-year observation period, 719 patients were treated with multiple or combined maxillofacial trauma, brain injuries and polytrauma. Mainly with isolated midface bones (49.7%), pan-facial (34.6%), mandible (12.9%), and frontal bone and walls (2.8%) fractures. Mortality was (2.2%). The mortality rates in patients with severe pan-facial fractures were higher (p = 0.008) than in single anatomical area (6% vs 1.5%). Age, GCS, and NISS were the most reliable indicator of lethal outcome. CONCLUSION: Age, Glasgow Coma Scale and New Injury Severity Score main factors, that predicts lethal outcome with high accuracy. New Injury Severity Score value ≥ 41 is a critical level for survival prognosis and should be considered in treatment planning and management of this category of patients.
PURPOSE: Identify the most common concomitant injuries associated with facial trauma, and compare the efficacy of various scoring systems in estimation of mortality risks in this category of patients. METHODS: The study evaluated patients with facial and concomitant injuries, who received the multidisciplinary treatment in a specialized trauma hospital. Values of New Injury Severity Score, Glasgow Coma Scale, Facial Injury Severity Scale, age, and length of hospital stay were statistically analysed to determine presence of relationships between these indicators and define factors that significantly associated with lethal outcome. RESULTS: During 6-year observation period, 719 patients were treated with multiple or combined maxillofacial trauma, brain injuries and polytrauma. Mainly with isolated midface bones (49.7%), pan-facial (34.6%), mandible (12.9%), and frontal bone and walls (2.8%) fractures. Mortality was (2.2%). The mortality rates in patients with severe pan-facial fractures were higher (p = 0.008) than in single anatomical area (6% vs 1.5%). Age, GCS, and NISS were the most reliable indicator of lethal outcome. CONCLUSION: Age, Glasgow Coma Scale and New Injury Severity Score main factors, that predicts lethal outcome with high accuracy. New Injury Severity Score value ≥ 41 is a critical level for survival prognosis and should be considered in treatment planning and management of this category of patients.
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