Isolated facial fractures transferred for higher level of care

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.