A Nationwide Study of Skiing and Snowboarding-Related Facial Trauma

2021 ◽  
pp. 194338752199723 ◽  
Author(s):  
Thomas J. Sorenson ◽  
Vedant Borad ◽  
Warren Schubert
Keyword(s):  
Surveillance System ◽  
Pediatric Patients ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Facial Fracture ◽  
Cold Winter ◽  
Injury Surveillance System ◽  
Weighted Estimates ◽  
Patient Demographics ◽  
The Us

Study Design: Retrospective descriptive observational study. Purpose: Skiing and snowboarding offers valuable opportunities for outdoor physical activity throughout the cold winter months, but these activities can result in substantial personally injury. This study aimed to analyze trends in skiing and snowboarding-related facial trauma epidemiology. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for facial trauma related to skiing and snowboarding treated in United States (US) emergency departments between 2010 and 2019. These data and weighted estimates were used to analyze patient demographics, injury location, and etiology. Results: A total of 361 skiing or snowboarding-related facial injuries were recorded. Lacerations were most common injury (165/361; 45.7%), and facial fractures occurred in 21.6% (78/261) of patients. The most common facial fracture locations are the nose (38/78; 48.7%), orbit (17/78; 21.8%), and mandible (15/78; 19.2%). Pediatric patients accounted for 52% (187/361) of these injuries and had higher rates of lacerations (51.9% vs 39.1%, P < 0.05) and hospital admission (4.8% vs 1.15%, P < 0.05) than adults. Adults had a higher rate of facial fracture (30% vs 13.9%, P < 0.001) than children. Conclusions: Skiing and snowboarding-related facial trauma is relatively uncommon in the US. In general, these injuries are largely decreasing, but facial fractures still occur not infrequently during these activities. Based on our data, we strongly urge helmet manufacturers to increase the availability of recreational snowsport helmets that include nose, orbit, and mandible protections, which could help to prevent many of these injuries.

UNDERSTANDING REAL-WORLD BIOLOGIC MAINTENANCE DOSING PATTERNS AMONG PEDIATRIC ULCERATIVE COLITIS AND CROHN’S DISEASE PATIENTS

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S23-S23
Author(s):  
Wallace Crandall ◽  
Richard Colletti ◽  
Wendy Komocsar ◽  
Chunyan Liu ◽  
Jennifer Dotson ◽  
...  
Keyword(s):  
Maintenance Dose ◽  
Pediatric Patients ◽  
Descriptive Statistics ◽  
Patient Demographics ◽  
Baseline Visit ◽  
The Us ◽  
Inflammatory Bowel ◽  
Using Data ◽  
Term Maintenance

Abstract Objectives To assess the initial and long-term maintenance dosing of biologic medications in pediatric UC and CD patients, using data in the ICN registry. Methods Pediatric patients (2–17 years) in the US who were diagnosed with UC or CD between June 1, 2013 and December 31, 2019, who, after enrollment in the ICN registry, initiated a biologic (adalimumab, infliximab, certolizumab, golimumab, ustekinumab, vedolizumab, and natalizumab) and were actively followed for at least 12 months after first maintenance dose were included in this study. Descriptive statistics of baseline patient demographics were summarized for the overall Inflammatory Bowel Disease (IBD) patient population and separately for UC and CD. Biologic maintenance dosage was calculated for UC and CD patients who had data for both dose and weight for each biologic at the baseline visit (first maintenance dose), 1-year and 3-year time points. Results A total of 1,887 pediatric IBD patients (UC=350; CD=1,537) were included in this study. Patients had a mean age at diagnosis of 12.9 years (UC=13.1; CD=12.9), 57.1% were male (UC=48.9%; CD=59.0%), and 80.6% were White (UC=79.8%; CD=80.8%) (Table 1). Infliximab (77.0%) was the most commonly prescribed biologic for UC, followed by adalimumab (12.4%), vedolizumab (10.1%), certolizumab (0.3%), and ustekinumab (0.3%). Similarly, infliximab (80.6%) was the most commonly prescribed biologic for CD, followed by adalimumab (16.5%), vedolizumab (1.6%), ustekinumab (1.2%), and certolizumab (0.1%) (Table 2). At first maintenance dose, UC patients on infliximab were receiving a mean dose of 10.5mg/kg/8wk, patients on adalimumab (weight &lt;40kg) were receiving a mean dose of 1.3mg/kg/2wk, patients on adalimumab (weight≥40kg) were receiving a mean dose of 0.8mg/kg/2wk, and patients on vedolizumab were receiving a mean dose of 6.9mg/kg/8wks. Mean dose of infliximab among UC patients increased from 10.5mg/kg/8wk at first maintenance dose to 11.8mg/kg/8wk at 1-year from first maintenance dose. At the first maintenance dose, CD patients on infliximab were receiving a mean dose of 8.1mg/kg/8wk, patients on adalimumab (weight &lt;40kg) were receiving a mean dose of 1.1mg/kg/2wk, patients on adalimumab (weight ≥40kg) were receiving a mean dose of 0.8mg/kg/2wk, patients receiving vedolizumab were receiving a mean dose of 10.5mg/kg/8wks. Mean dose of infliximab among CD patients increased from 8.1mg/kg/8wk at first maintenance dose to 9.6mg/kg/8wk at 1-year from first maintenance dose. Conclusion These results highlight the biologic maintenance dose changes among pediatric UC and CD patients. TNF inhibitors remain the most commonly used class of biologic, but the doses being used are double the standard dosing guidelines. There is little evidence of dose reduction over time among pediatric UC and CD patients in the ICN registry.

scholarly journals South Australian facial trauma: a population analysis of social economic deprivation and facial fractures

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Jason Diab ◽  
Benjamin Grave ◽  
Walter Flapper ◽  
Peter Anderson ◽  
David J David ◽  
...  
Keyword(s):  
Population Analysis ◽  
Maxillofacial Surgery ◽  
Adelaide Hospital ◽  
Socioeconomic Disadvantage ◽  
Facial Trauma ◽  
Royal Adelaide Hospital ◽  
Facial Fractures ◽  
Facial Fracture ◽  
Operative Notes ◽  
The Relationship

Background: Trauma remains a leading cause of morbidity and mortality in Australia. The objective of this South Australian study was to analyse epidemiological trends in facial fractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. Part one of this paper includes methods and results; part two includes discussion and conclusion. The two papers should be read together. Method: A retrospective analysis of the relationship was conducted between socioeconomic disadvantage and facial fractures. All paediatric and adult patients with facial fractures who attended the Royal Adelaide Hospital and the Women’s and Children’s Hospital Adelaide between January 2012 and January 2017 either as in- or outpatients. The medical records, progress notes, imaging and operative notes from plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted from the RAH Human Research and Ethics Committee [HREC/17/RAH/402]. Results: A total of 2559 patients, 1976 males (77.2%) and 583 females (22.8%), sustained a facial fracture. The most disadvantaged group had the highest proportion of facial fractures (36.9%), with the highest incidence in the 25–34 age group (22.4%). Assaults were the most common injury with decreasing odds as socioeconomic advantage increased (p<0.05). Orbitozygomatic fractures were the most common type of facial fracture (27.7%). Indigenous patients were more likely (OR=2.8) to have surgery compared to non–indigenous patients (p<0.05). There were no significant differences in length of stay between socioeconomic groups (F(4,964.387)=2.091, p = 0.080). Conclusion: Socioeconomic status strongly influences the mechanisms on injury, types of fracture and likelihood of surgery with the most disadvantaged having higher rates compared to the least disadvantaged.

Fishing-Related Injuries Among Pediatric Patients Treated in United States Emergency Departments, 1997 to 2016

2018 ◽  
Vol 57 (14) ◽  
pp. 1656-1663
Author(s):  
Tyler Vajdic ◽  
Kelly R. Bergmann ◽  
Alicia Zagel ◽  
Henry Ortega
Keyword(s):  
Emergency Departments ◽  
Surveillance System ◽  
Pediatric Patients ◽  
Severe Trauma ◽  
Recreational Fishing ◽  
Injury Patterns ◽  
Injury Surveillance System ◽  
Linear Regressions ◽  
Over Time ◽  
Age And Sex

An estimated 14.8 million youth under the age of 25 years participate in recreational fishing. Despite its popularity, fishing can be associated with injuries ranging from mild to severe trauma. There is a paucity of research available that describes characteristics of fishing-related injuries among youth. We examined the National Electronic Injury Surveillance System 1997-2016 to describe injury patterns by age and sex. Linear regressions estimated changes in injuries over time. There were an estimated 412 171 pediatric patients treated in US emergency departments for fishing-related injuries. The majority of injuries occurred in males (81.4% [95% confidence interval [CI]: 80.3-82.6]) and in youth ages 11 to 18 years (53.7% [95% CI: 51.0-56.5]). Injuries were most likely due to hooks and lures (79.7% [95% CI: 75.7-83.7]), and the arm/hand accounted for 43.9% of injuries (95% CI: 42.5-45.2). Based on these findings, we suggest that injury prevention efforts should be focused on older male children and wearing appropriate clothing.

Comparison of Chinese and American Product Injury Features

2014 ◽  
Vol 670-671 ◽  
pp. 1616-1619
Author(s):  
Yong Qin Feng ◽  
Yan Yin ◽  
Xiao Rui Zhang ◽  
Zhi Li Xie
Keyword(s):  
Gender Difference ◽  
Surveillance System ◽  
Senior Citizens ◽  
Injury Surveillance ◽  
Injury Surveillance System ◽  
Injury Data ◽  
The Us ◽  
Working Age ◽  
Working Age Population ◽  
By Products

Based on the product injury data provided by the National Electronic Injury Surveillance System (NEISS) in the US and the National Injury Surveillance System (NISS) in China, different features of Chinese and American product injuries have been analyzed. American product injuries are mainly focused on children, teenagers and senior citizens, while Chinese product injuries are mainly focused on working-age population. In the US, the percentage of men injured by products is close to that of women. But in China, the percentage of men injured by products is almost twice that of women, showing a distinct gender difference. In the US, the percentage of people injured by product treated and recovered is higher than in China, while the percentage of the hospitalized and dead is lower than in China.

scholarly journals Patterns of Intracranial Hemorrhage in Pediatric Patients with Facial Fractures

2016 ◽  
Vol 9 (1) ◽  
pp. 035-039 ◽  
Author(s):  
Andrew A. Marano ◽  
Ian C. Hoppe ◽  
Jordan N. Halsey ◽  
Anthony M. Kordahi ◽  
Mark S. Granick ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Pediatric Patients ◽  
Motor Vehicle ◽  
External Ventricular Drain ◽  
Mandibular Fractures ◽  
Facial Fractures ◽  
Facial Fracture ◽  
Facial Skeleton ◽  
Gunshot Injuries ◽  
Fracture Patterns

Intracranial hemorrhage (ICH) is a potentially fatal injury accompanying fractures of the cranium and facial skeleton. When occurring at a young age, ICH can lead to developmental delay, cerebral palsy, epilepsy, and death. It is therefore important for clinicians to recognize the presence of ICH early, and understand the factors that affect its prognosis. In this study, we aim to identify diagnostic and prognostic signs for ICH in pediatric facial fracture patients by examining aspects of patient presentation, concomitant injuries, and fracture patterns. Data were collected for all radiologically diagnosed facial fractures between January 2000 and December 2012 at a level I trauma center in Newark, NJ. This was then further refined to include only patients 18 years of age or younger who had a documented ICH. Patient age, Glasgow coma scale (GCS) on presentation, fracture location, type of hemorrhage, and certain aspects of management were collected from these records. Data were then analyzed by either Pearson chi-square test or a t-test to determine significant relationships. A total of 285 pediatric patients were found to have sustained a facial fracture during this time period, 67 of which had concomitant ICH; 46 of these patients were male and 21 were female, with average ages of 14.26 and 9.52 ( p < 0.01), respectively. Causes of injury included motor vehicle accidents, pedestrians struck, assault, falls, gunshot injuries, and sports-related injuries. All patients who suffered injuries as a result of violent crimes (assault and gunshot injuries) were male. Although nearly all fracture patterns were significantly associated with the presence of ICH, mandibular fractures showed a significant negative association with the presence of ICH. In addition, patients who received surgical intervention were significantly younger than those who did not (7.7 vs. 13.7, p < 0.05). The GCS was significantly lower in patients who underwent ICP (intracranial pressure) monitoring or EVD (external ventricular drain) placement, suffered intraventricular hemorrhage, experienced worsening of hemorrhage on repeat imaging, and suffered fatal injuries. Our data also showed a significant association between the need for intubation in the emergency department and fatality. Because the consequence of ICH can be life threatening, proper diagnosis and management are imperative. The purpose of this study is to describe patterns associated with ICH in pediatric facial fracture patients to promote early recognition of the injury and understanding of poor prognostic signs.

Pediatric Scald Injuries Sustained From Instant Soup and Noodle Products

2020 ◽  
Vol 60 (1) ◽  
pp. 16-19
Author(s):  
Courtney E. Allen ◽  
Janet Figueroa ◽  
Maneesha Agarwal ◽  
Wendalyn K. Little
Keyword(s):  
United States ◽  
Pediatric Patients ◽  
Body Part ◽  
The United States ◽  
Burn Injuries ◽  
Care Utilization ◽  
Body Area ◽  
Injury Surveillance System ◽  
Patient Demographics ◽  
Included Patient

Background and Objective. Scald burns are a major cause of pediatric burn injuries. Instant soups have been identified as one source of these injuries. This study aims to quantify and characterize these injuries in pediatric patients. Methods. Ten-year query of National Electronic Injury Surveillance System (NEISS) database identified instant soup- and noodle-related scald burns in children aged 4 to 12 years. Data included patient demographics, injured body part, case narratives, and emergency department disposition. Results. A total of 4518 cases were identified, yielding an estimate of 9521 cases/year in the United States. Younger children were affected more than the older. Trunk was the most commonly burned body area. Approximately 10% of injuries required admission or transfer for further care. Conclusion. Instant soup and noodle products are a common cause of pediatric scald burns, potentially injuring 25 children per day in the United States and leading to high rates of health care utilization.

Fire Pit-Related Burn Injuries in Children and Adolescents

2019 ◽  
Vol 40 (6) ◽  
pp. 943-946
Author(s):  
Michael R Flaherty ◽  
Robert Sheridan
Keyword(s):  
Children And Adolescents ◽  
Surveillance System ◽  
Pediatric Patients ◽  
Public Awareness ◽  
Burn Injuries ◽  
Population Estimates ◽  
Regression Analyses ◽  
Injury Surveillance System ◽  
Awareness Campaigns ◽  
Ed Visits

Abstract Thermal burns are a leading cause of preventable injury in children and adolescents. Fire pits have become increasingly popular outdoor fixtures in U.S. homes. We aimed to identify trends in pediatric burn injuries related to fire pits that presented to a representative sample of United States Emergency Departments (EDs). A retrospective analysis of annual ED visits from the National Electronic Injury Surveillance System (NEISS) from January 1, 2006 through December 31, 2017 using product codes specific to fire pits. U.S. Census population estimates were used to compute rates per 100,000 population. SAS and Joinpoint weighted regression analyses were used to analyze annual estimates and rate trends across the study period. There were 10,951 (95% CI = 8535–13,367) ED visits for burn injuries secondary to outdoor fire pits in patients 19 years of age and younger across the study period. The majority of injuries occurred in children under the age of 5, and were related to falls into or on a hot fire pit. The annual modeled rate change showed an overall significant increase in burn injuries of 7.16 per 100,000 annually from 2006 to 2017 (P = .02). Outdoor fire pits represent an increasing hazard to young children who are particularly susceptible to burn injuries from falls in or around lit recreational fires. Product modifications and public awareness campaigns are necessary to prevent future life-altering injuries in pediatric patients.

scholarly journals South Australian facial trauma: a population analysis of social economic deprivation and facial fractures

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Jason Diab ◽  
Benjamin Grave ◽  
Walter Flapper ◽  
Peter Anderson ◽  
David J David ◽  
...  
Keyword(s):  
Population Analysis ◽  
Maxillofacial Surgery ◽  
Adelaide Hospital ◽  
Socioeconomic Disadvantage ◽  
Facial Trauma ◽  
Royal Adelaide Hospital ◽  
Facial Fractures ◽  
Facial Fracture ◽  
Operative Notes ◽  
The Relationship

Background: Trauma remains a leading cause of morbidity and mortality in Australia. The objective of this South Australian study was to analyse epidemiological trends in facial fractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. Part one of this paper includes methods and results; part two includes discussion and conclusion. The two papers should be read together. Method: A retrospective analysis of the relationship was conducted between socioeconomic disadvantage and facial fractures. All paediatric and adult patients with facial fractures who attended the Royal Adelaide Hospital and the Women’s and Children’s Hospital Adelaide between January 2012 and January 2017 either as in- or outpatients. The medical records, progress notes, imaging and operative notes from plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted from the RAH Human Research and Ethics Committee [HREC/17/RAH/402]. Results: A total of 2559 patients, 1976 males (77.2%) and 583 females (22.8%), sustained a facial fracture. The most disadvantaged group had the highest proportion of facial fractures (36.9%), with the highest incidence in the 25–34 age group (22.4%). Assaults were the most common injury with decreasing odds as socioeconomic advantage increased (p<0.05). Orbitozygomatic fractures were the most common type of facial fracture (27.7%). Indigenous patients were more likely (OR=2.8) to have surgery compared to non–indigenous patients (p<0.05). There were no significant differences in length of stay between socioeconomic groups (F(4,964.387)=2.091, p = 0.080). Conclusion: Socioeconomic status strongly influences the mechanisms on injury, types of fracture and likelihood of surgery with the most disadvantaged having higher rates compared to the least disadvantaged.

Injury Patterns in Pediatric Facial Fractures Unique to an Urban Environment

2021 ◽  
Author(s):  
Anthony P. Sclafani ◽  
Matthew Scott Sclafani ◽  
Sallie Long ◽  
Tasher Losenegger ◽  
Daniel Spielman ◽  
...  
Keyword(s):  
Urban Environment ◽  
Older Patients ◽  
High Energy ◽  
Urban Setting ◽  
Cranial Bone ◽  
Csf Leak ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Associated Injuries ◽  
Facial Fractures

AbstractThis study aimed to define better the clinical presentation, fracture patterns, and features predictive of associated injuries and need for surgery in pediatric facial trauma patients in an urban setting. Charts of patients 18 years or younger with International Classification of Disease 9th and 10th revision (ICD-9/ICD-10) codes specific for facial fractures (excluding isolated nasal fractures) at NY-Presbyterian/Weill Cornell Medical Center between 2008 and 2017 were retrospectively reviewed. Of 204 patients, most were referred to the emergency department by a physician's office or self-presented. Children (age 0–6 years) were most likely to have been injured by falls, while more patients 7 to 12 years and 13 to 18 years were injured during sporting activities (p < 0.0001). Roughly half (50.5%) of the patients had a single fracture, and the likelihood of surgery increased with greater numbers of fractures. Older patients with either orbital or mandibular fractures were more likely to undergo surgery than younger ones (p = 0.0048 and p = 0.0053, respectively). Cranial bone fractures, CSF leaks, and intracranial injuries were more common in younger patients (p < 0.0001) than older patients and were more likely after high energy injuries; however, 16.2% of patients sustaining low energy injuries also sustained cranial bone, CSF leak, or intracranial injury. In an urban environment, significant pediatric facial fractures and associated injuries may occur after nonclassic low kinetic energy traumatic events. The age of the patient impacts both the injuries sustained and the treatment rendered. It is essential to maintain a high index of suspicion for associated injuries in all pediatric facial trauma patients.

Trends in Craniofacial Injuries Associated with the Introduction of Electric Scooter Sharing Services

FACE ◽  
2021 ◽  
pp. 273250162199244
Author(s):  
Elizabeth M. Boudiab ◽  
Thomas D. Zaikos ◽  
Christopher Issa ◽  
Kongkrit Chaiyasate ◽  
Stephen M. Lu
Keyword(s):  
Maxillofacial Surgery ◽  
Age Groups ◽  
Injury Surveillance System ◽  
Patient Demographics ◽  
Time Period ◽  
Electric Scooter ◽  
Before And After ◽  
Trends Over Time ◽  
Patterns Of Injury ◽  
Craniofacial Fractures

Electric scooters are an increasingly common and convenient mode of transportation worldwide and have effectively revolutionized the shared micromobility industry. As electric scooter sharing companies have increased in popularity there has been a concomitant increase in the frequency of all electric scooter-related injuries. The purpose of this study is to describe the most up-to-date trends in craniofacial fractures and lacerations related to electric scooter use among all age groups. We queried the National Electronic Injury Surveillance System (NEISS) for craniofacial fractures and lacerations related to e-scooters between 2010 and 2019. We then compared injury trends over time and between time periods before and after 2017 when electric scooter share apps revolutionized micromobility. We compared incidence of injury overall and by day of the week, patient demographics, and case severity based on clinical disposition. We identified an increase in the frequency of craniofacial lacerations and fractures in the 3 years following the introduction of electric scooter share services in 2017 (2017 and 2019), compared to the 3 years before this time (2014-2016). Young adults (18-39 years) were the age group with the greatest interval increase in craniofacial injuries. There was also an increase in number of craniofacial injuries occurring on Mondays and a decrease number occurring on Fridays in the later time period. Finally, patients who presented with electric scooter-related craniofacial injuries in this later time period showed a higher frequency of overnight observation and hospital admission for their injuries. The number of craniofacial injuries secondary to electric scooter use has increased dramatically since the introduction of share services. Craniofacial fractures and lacerations are a common reason for craniofacial or maxillofacial surgery consultation and understanding these patterns of injury will help prepare surgeons for patient care, preventative education, and public advocacy.

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