Identifying risk factors of cerebrovascular injuries following blunt mandible fracture; a retrospective study from a national data base
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The purpose of this study was to determine the risk factors of cerebrovascular injury (CVI) in patients with blunt mandible fractures.
All patients who sustained a mandible fracture as a result of blunt force trauma from the 2012–2014 National Trauma Data Bank from the United State of America were included in the study. A CVI was noted as having occurred if there was an injury to the vertebral or carotid artery in the neck. Patients’ demography, injury mechanism, and additional fractures were compared between the groups of patients with and without CVI using univariate analyses. In addition, a multivariate logistic regression model was fit to identify risk factors for CVI in this cohort. All two-sided p values < 0.05 were considered statistically significant.
Out of 29,398 patients who qualified for the study, only 398 (1.4%) patients sustained a CVI. There were significant differences (p < 0.001) identified between the groups regarding sex, race, mechanism of injury, occurrence of c-spine fracture, and of Le Fort II and III fractures in the univariate analysis. The risk factors identified by the multiple logistic regression model echoed these results and showed that female gender, injuries due to motorcycle, motor vehicle crashes and the presence of a cervical spine or Le Fort fracture were all associated with the occurrence of CVI (p < 0.05).
The patients with mandible fracture who were female and sustained a high impact blunt force mechanism had a significantly higher risk of CVI. These high-risk patients should be screened for CVI at the time of initial evaluation.
KeywordsBlunt mandibular fractures High impact mechanism Cerebrovascular injuries
Nasim Ahmed conceived and designed the study. Nasim Ahmed was responsible for retrieving the study data, while Patricia Greenberg performed the data analysis. Nasim Ahmed and Patricia Greenberg and Kayvon Haghighi all contributed to manuscript writing and both were responsible for all follow-up manuscript revisions.
There was no funding provided for this study.
Compliance with ethical standards
Conflict of interest
None of the contributing authors have a conflict of interest to disclose, financial or otherwise.
All procedures followed were accordance with the ethical standards of the Institutional Review Board of Meridian Health and with the Helsinki Declaration of 1975, as revised in 2008. Since the data of NTDB are de-identified patient’s information available to the researchers, the study was exempted from Meridian Health IRB review.
Given this retrospective study was performed from the de-identified National database from the American College of Surgeons that is available to all researches, this study was exempted from the IRB review as per policy and no informed consent was required.
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