Highlights
- •IFF are often nonoperative and require few urgent interventions.
- •IFF are often transferred to level I traumas centers in an emergent setting.
- •There is a need for IFF transfer guidelines, telehealth, and outpatient referral via a multidisciplinary collaboration.
Abstract
Background
Isolated facial fractures (IFF) have been identified as overtriaged injuries in multiple
single-center studies. We sought to describe IFF in a national database.
Methods
The 2019 Trauma Quality Improvement Program database was queried for all patients
with facial fractures and Abbreviated Injury Score<1 for other body regions. Descriptive
statistics were performed.
Results
Of 1,097,190 trauma patients, 36,077 (3.3%) had IFF. Median age was 39 [26–89], 92%
had blunt mechanism, median Glasgow Coma Scale 15 [15-15], and vital signs were normal
(ED systolic blood pressure 137 [125–153], ED pulse 86 [73–99]). 0.3% required unplanned
intubation. 25.7% underwent operation after a median interval 26.4 [14.4–47.9] hours.
IFF patients represented 4.4% of interfacility transfers and were more likely to have
been transferred (34.4% vs 25%, p < 0.001). Hospital stay was 3 [2–4] days.
Conclusions
IFF are rarely surgical emergencies and frequently nonoperative, yet are disproportionately
represented among transfers. IFFs may represent an opportunity for outpatient follow-up
or telehealth consultation to decrease resource utilization.
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Article info
Publication history
Published online: September 21, 2022
Accepted:
September 18,
2022
Received in revised form:
August 20,
2022
Received:
April 17,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
