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Epidemiological Trends and Risk Factors

Brian T. McMullin, MD; John S. Rhee, MD, MPH; Frank A. Pintar, PhD; Aniko Szabo, PhD; Narayan Yoganandan, PhD

Arch Facial Plast Surg. 2009;11(3):165-170.

Objectives  To analyze epidemiological trends in facial fractures sustained in motor vehicle collisions and to identify the effects of occupant and crash-specific characteristics on the likelihood of injury.

Methods  A retrospective cohort analysis of vehicle occupants with facial fractures following a motor vehicle crash was performed using the population-based 1993-2005 National Automotive Sampling System Crashworthiness Data System database. Injury trends were analyzed by calendar year and vehicle model year. A multivariate analysis was performed on biomechanical, demographic, and safety restraint data, with the calculation of odds ratios (ORs) and 95% confidence intervals (CIs).

Results  The incidence of facial fractures was found to be decreasing (P < .01), along with a declining probability of injury with newer car models (P < .01). Seat belts with frontal air bag use were associated with a significantly decreased probability of facial fracture (OR, 0.14; 95% CI, 0.09-0.22). Air bags alone were not associated with a reduced probability of injury (OR, 0.78; 95% CI, 0.58-1.06). Side impacts (OR, 1.81; 95% CI, 1.14-2.86) and mismatch in the sizes of the crash vehicles (OR, 1.99; 95% CI, 1.27-3.12) were associated with increased risk of facial fractures.

Conclusions  The probability of facial fractures from motor vehicle collisions is decreasing. This finding may be due to design improvements implicitly related to vehicle model year. Restraint use continues to be important for injury prevention, while factors such as changes in vehicle fleet composition may alter injury trends.

Author Affiliations: Departments of Otolaryngology and Communication Sciences (Drs McMullin and Rhee), Neurosurgery (Drs Pintar and Yoganandan), and Population Health (Dr Szabo), Medical College of Wisconsin, and the Zablocki Veteran Affairs Medical Center (Drs Rhee, Pintar, and Yoganandan), Milwaukee.

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