Classifying and standardizing panfacial trauma according to anatomic categories and Facial Injury Severity Scale: a 10-year retrospective study

Abstract Background The purpose of this study was to identify the epidemiologic factors of panfacial fractures (PFs), and to evaluate the significance of anatomic PF categories and the Facial Injury Severity Scale (FISS) in classifying and standardizing panfacial injuries. Methods A retrospective review of all patients treated with PFs at our institution between June 2010 and April 2021 was performed. PF was defined as a concurrent fracture in at least 3 of 4 facial subunits (frontal, upper midface, lower midface, and mandible). Data regarding patient demographics, causes of injury, location of fractures, major concomitant injuries, and postinjury complications were collected, and the FISS score was collected from each patient. Statistical analysis was performed using IBM SPSS Statistics version 22.0. Results A total of 227 patients were enrolled. The most commonly fractured bones were the maxillary sinus wall (92.1%), mandible (82.8%), and zygomatic arch (75.3%), and the most common fracture sites in PFs were graphically presented. Four PF patterns were defined: FULM (n = 60), FUL (n = 39), ULM (n = 127), and FUM (n = 1). There was a significant association between PF patterns and sex (p = 0.018), the number of concomitant injuries (p = 0.014), and early surgical airway management (p = 0.003). Different PF patterns were significantly correlated with different types of concomitant injuries and complications. The FISS score showed a significant difference with PF patterns (p = 0.000) and sex (p = 0.007), and a FISS value of 11 or more is the appropriate cutoff for the prediction of multiple concomitant injuries and complications. Conclusions Both the anatomic PF categories and FISS were significantly correlated with various concomitant injuries and complications. The combination of PF categories and FISS provided a better positive and negative prediction of concomitant injuries and complications for PF patients. Patients with FULM and FISS > 11 had an obviously higher proportion of the need for multiprofessional treatment.

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Traumatic Liver Injury in Hong Kong: The Management Strategy and Outcome

Hong Kong Journal of Emergency Medicine ◽

10.1177/102490790901600403 ◽

2009 ◽

Vol 16 (4) ◽

pp. 208-216 ◽

Cited By ~ 1

Author(s):

CN Chong ◽

YS Cheung ◽

KF Lee ◽

TH Rainer ◽

BSP Lai

Keyword(s):

Hong Kong ◽

Liver Injury ◽

Hospital Stay ◽

Injury Severity ◽

Road Traffic ◽

Demographic Data ◽

Operative Management ◽

Concomitant Injuries ◽

Significant Difference ◽

Non Operative Management

Introduction Management of liver injury is challenging and evolving. The aim of this article is to review the outcome of traumatic liver injury in Chinese people in Hong Kong. Materials & methods Records of 40 patients with hepatic injury who received treatment at the Prince of Wales Hospital between December 2000 and May 2005 were reviewed. Demographic data, severity of liver injury, Injury Severity Score (ISS), haemodynamic status and Glasgow Coma Scale (GCS) score on admission, investigations made, concomitant injuries, management scheme, and outcome of patients were analysed. Results There were 23 male and 17 female patients with a mean age of 31.3 (SD=15.4) years. Road traffic accident was the most common injury mechanism (65%). Half of the patients were treated by non-operative management (NOM). None of them required surgery during subsequent management. Patients in the operative management (OM) group had a significantly higher ISS (p=0.026), but there was no significant difference in the mortality rate between the OM and NOM groups. Patients with stable haemodynamic status and who were treated non-operatively had a significantly shorter hospital stay (p=0.006). High grade liver injury (OR=8.0, 95% CI=1.2 to 53.8, p=0.03) and ISS greater than 25 (OR=21.6, 95% CI=2.0 to 225.3, p=0.01) were independent risk factors for mortality on multivariate analysis. Conclusions Non-operative management of liver injury can be safely accomplished in haemodynamically stable patients, with the possible benefit of a shorter hospital stay.

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Maxillofacial Fractures of Pedestrians Injured in a Motor Vehicle Accident

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0033-1333881 ◽

2013 ◽

Vol 6 (1) ◽

pp. 37-41 ◽

Cited By ~ 6

Author(s):

Kazuhiko Yamamoto ◽

Yumiko Matsusue ◽

Satoshi Horita ◽

Kazuhiro Murakami ◽

Yoshihiro Ueyama ◽

...

Keyword(s):

Injury Severity ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

The Body ◽

Facial Injury ◽

Severity Scale ◽

Motor Vehicle Collisions ◽

Vehicle Collisions ◽

Vehicle Accident ◽

Maxillofacial Fractures

Maxillofacial fractures of pedestrians injured in a motor vehicle accident were retrospectively analyzed. The patients were 38 males and 26 females, and their age was distributed almost evenly from 1 to 91 years old (average 45.9 ± 24.8 years old). Motor vehicle collisions were with an automobile in 46 patients (71.9%), a motorcycle in 17 (26.6%), and a train in 1 (1.6%). The midface was involved in 32 patients (50.0%), the mandible in 19 (29.7%), and both the mandible and the midface in 13 (20.3%). Fractures were frequently observed in the zygoma and alveolus in the midface and in the condyle, symphysis, and body in the mandible. The facial injury severity scale (FISS) rating ranged from 1 to 9 (average 2.30 ± 1.79). Injuries to other sites of the body occurred in 29 patients (45.3%). Observation was most frequently chosen in 26 patients (40.6%), followed by open reduction and internal fixation (ORIF) in 18 (28.1%), and maxillomandibular fixation (MMF) in 8 (12.5%). The FISS rating was higher in patients treated with ORIF and MMF. Injuries to other sites of the body were observed at a higher rate in patients who collided with an automobile and were also treated by ORIF.

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Порівняльний аналіз відповідності результатів двох експертних підходів до кількісної оцінки травм щелепно-лицевої області

CLINICAL DENTISTRY ◽

10.11603/2311-9624.2019.3.10569 ◽

2019 ◽

pp. 25-31

Author(s):

P. P. Brechlychuk

Keyword(s):

Injury Severity Score ◽

Severity Score ◽

Injury Severity ◽

Facial Injury ◽

Severity Scale ◽

Maxillofacial Injury

Резюме. Актуальна проблема щодо розроблених на сьогодні підходів до експертної оцінки травм щелепно-лицевої ділянки полягає у різному рівні неузгодження таких між собою, враховуючи відмінності у методології їх реалізації. Мета дослідження – провести порівняльний аналіз відповідності результатів використання двох експертних підходів FISS (Facial Injury Severity Scale) та MFISS (Maxillofacial Injury Severity Score) у ході кількісної оцінки випадків травм щелепно-лицевої ділянки. Матеріали і методи. З метою реалізації мети дослідження проводили за участі 14 пацієнтів із діагностованими фактами травм щелепно-лицевої ділянки різного ступеня тяжкості. Кількісну оцінку травм щелепно-лицевої ділянки проводили із застосуванням двох експертних підходів FISS та MFISS. У ході статистичного опрацювання результатів виконували пошук середніх величин досліджуваних показників та рівнів стандартних похибок, визначення рівня кореляції між ними та перевірка достовірності ідентифікованих розбіжностей. Результати досліджень та їх обговорення. Результати проведеного аналізу відповідності щодо використання двох експертних підходів FISS та MFISS у ході кількісної оцінки випадків травм щелепно-лицевої ділянки встановили, що рівень кореляції між показниками, які отримали, серед пацієнтів досліджуваної групи складав r=0,65 (p<0,05), при цьому показник кореляції між показниками FISS та тривалістю госпіталізації складав r=0,71 (p<0,05), а між показниками MFISS та тривалістю госпіталізації – r=0,78 (p<0,05). Висновки. Враховуючи встановлений рівень кореляції між кінцевими показниками MFISS та FISS, та факт наявності корелятивного зв’язку між результатами оцінки травматичних уражень зубощелепного апарату та тривалістю госпіталізації, можна резюмувати доцільність проведення подальших досліджень, направлених на аспект уніфікації діагностичного алгоритму обстеження постраждалих із використанням експертних оцінок у структурі комплексного прогнозу ефективності майбутньої реабілітації та тенденцій щодо потенційного рівня втрати стоматологічного здоров’я.

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Hubungan Facial Injury Severity Scale dengan lama rawat inap pasien trauma maksilofasial di RSUP Prof. Dr R. D. Kandou Manado

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.9.1.2017.15382 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Richard Rampisela ◽

Nico Lumintang ◽

Jan T. Ngantung

Keyword(s):

Scoring System ◽

Injury Severity ◽

Pearson Correlation ◽

Maxillofacial Trauma ◽

Facial Trauma ◽

Minor Trauma ◽

Facial Injury ◽

Severity Scale ◽

Cross Sectional ◽

Maxillofacial Fractures

Abstract: Maxillofacial trauma includes soft tissue injuries, such as burns, bruises and contusions, as well as fractures of facial bones that form the maxillofacial structure. The causes of maxillofacial fractures are traffic accidents, falls, hits, gun shots, sport accidents, and industrial accidents. Scoring system has been introduced as a tool to determine the prognostic value of patients with trauma. Facial trauma requires a different scoring system due to many dysfunctions that can occur afterwards. This study was aimed to determine the length of stay (LOS) of inpatients by using Facial injury Severity Scale (FISS). This was a correlation analytical study with a cross sectional design performed on inpatients of emergency care installation and medical records at Prof. Dr. R. D. Kandou Hospital from January 2015 through April 2016. The results showed that there were 52 patients in this study. Most of them were males (49 cases; 94.2%), aged 17-25 years (16 cases; 30.8%), refused to be operated (40 cases; 76.9%), patients with FISS 1-3 (42 cases; 80.7%), minor trauma (FISS <3), and zygoma fracture cases. The Pearson correlation coefficient test showed an r value = 0.646 (P <0.001) which stated that there was a significant relationship between FISS and LOS. Conclusion: Most patients with maxillofacial trauma had a FISS value less than 3 (mild trauma). Moreover, this FISS value could be used to estimate the length of stay.Keywords: maxillofacial trauma, facial fractures, FISSAbstract: Trauma maksilofasial mencakup cedera jaringan lunak seperti luka bakar, mencakup cedera jaringan lunak seperti luka bakar, memar, fraktur tulang fasial yang membentuk sturktur maksilofasial. Penyebab fraktur maksiofasial ialah antara lain kecelakaan lalu lintas, jatuh, pukulan, tembakan, kecelakaan olah raga, dan kecelakaan kerja. Sistem skoring digunakan untuk menentukan nilai prognostik pasien dengan trauma. Trauma fasial memerlukan sistem skoring yang berbeda karena banyak disfungsi yang dapat terjadi. Penelitian ini bertujuan untuk menentukan lama rawat inap dari pasien cedera fasial dengan menggunakan Facial injury Severity Scale (FISS). Jenis penelitian ialah korelasi analitik dengan desain potong lintang terhadap pasien rawat ianap dengan trauma maksilofasial di Instalasi Gawat Darurat dan Bagian Rekam Medik RSUP Prof. Dr. R. D. Kandou periode Januari 2015 s/d April 2016. Hasil penelitian mendapatkan 52 pasien dengan trauma maksilofasial. Sebagian besar pasien ialah laki-laki (49 kasus; 94,2%), berusia 17-25 tahun (16 kasus; 30,8%), menolak dioperasi (40 kasus; 76,9%), nilai FISS 1-3 (42 kasus; 80,7%), trauma ringan (FISS <3), dan fraktur tulang zygoma. Uji korelasi Pearson mendapatkan nilai r = 0,646 (P < 0,001) yang menunjukkan terdapatnya hubungan bermakna antara FISS dan lama rawat inap. Simpulan: Umumnya pasien dengan trauma maksilofasial mempunyai nilai FISS 3 (trauma ringan). FISS mempunyai nilai prognostik terhadap lama rawat inap.Kata kunci: trauma maksilofasial, fraktur fasial, FISS

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Facial Injury Severity Scale Score as a Predictor of Length of Stay for Maxillofacial Fracture at Sanglah General Hospital, Denpasar, Bali, Indonesia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4231 ◽

2020 ◽

Vol 8 (B) ◽

pp. 291-294

Author(s):

Esther Felicita Tambayong ◽

Nengah Kuning Atmadjaya ◽

Nyoman Golden ◽

Ketut Wiargitha ◽

Gede Bagus Mahadewa Tjokorda

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Length Of Stay ◽

General Hospital ◽

Injury Severity ◽

Linear Regression Analysis ◽

Facial Injury ◽

Severity Scale ◽

Operating Characteristics ◽

Maxillofacial Fracture

INTRODUCTION: Maxillofacial fracture is the most common trauma that happened in the developing countries. One of the methods to evaluate the severity of maxillofacial fracture is by using the Facial Injury Severity Scale (FISS) score. Maxillofacial trauma causes multiple injuries, thus resulted in various periods of hospitalization. AIM: The aim of this study is to use the employment of the FISS score to predict a patient’s length of stay. METHODS: This research was a retrospective cohort and cross-sectional study on maxillofacial fracture patients whom treated in Sanglah General Hospital, Denpasar, Bali. As much as 89 subjects were included in this study and information about their age, gender, mechanism of injury, FISS score, treatments, and length of stay was collected. The data were statistically analyzed using bivariate, receiver operating characteristics (ROC), and linear regression analysis. RESULTS: A total of 89 subjects were included in this study. Among them, 50 subjects had a high FISS score, and 39 subjects had low FISS score. The average age was 28.9 ± 13.3 years with a mean length of stay 6.39 ± 4.29 days. Bivariate analysis showed that the patients with high FISS score have 5.3 times higher risk to get a longer length of stay compared to those with low FISS score (95% CI: 2.289–12.289; p = 0.001). The mean of length of stay in subjects with a high FISS score was significantly higher compared to subjects with a low FISS score (mean for subjects with high score: 8.46 ± 4.63; mean for subjects with low score: 3.74 ± 1.46; p = 0.001) with a correlation value r = 0.718 (p = 0.001). ROC analysis represented that FISS score ˂4 was categorized as mild. The linear regression analysis showed that the length of stay for maxillofacial fracture patients was able to be predicted by LOS = 1.476 + 1.032 × FISS score. CONCLUSION: The FISS score can predict the length of stay for patients with maxillofacial fracture.

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Relationship of the Severity of Maxillofacial Trauma Based on Facial Injury Severity Scale (FISS) Against the Severity of Head Injury

Sriwijaya Journal of Surgery ◽

10.37275/sjs.v2i1.12 ◽

2019 ◽

Vol 2 (1) ◽

pp. 9-21

Author(s):

Ary Rachmanto ◽

Abda Arif

Keyword(s):

Head Injury ◽

Injury Severity ◽

Bone Fractures ◽

Head Injuries ◽

Secondary Data ◽

Maxillofacial Trauma ◽

Trauma Patients ◽

Facial Injury ◽

Severity Scale ◽

Cross Sectional

ABSTRACT Introduction. Facial bone fractures can be accompanied by life-threatening complications such as head injuries. Maxillofacial trauma increases with time. The maxillofacial facial injury severity scale (FISS) scoring system was introduced to assess the patient's severity, prognosis, and outcome. Maxillofacial FISS has predictive value on the severity of head injuries. Method. This research uses analytic observation method with cross sectional design approach. The population and sample were all maxillofacial trauma patients who had been treated at RSUP dr. Moehammad Hoesin Palembang from January-September 2018. Data is taken from secondary data, namely the patient's medical record. Results. The incidence of maxillofacial trauma at RSUP dr. Moehammad Hoesin Palembang is 95 cases. The most cases occurred in the age group <30 years (62.1%). Gender male (85.3%), the scene outside the city (52.6%). There were 21 maxillofacial trauma patients undergoing neurosurgery (22.1%). There was no relationship between FISS and the severity of head injury (p = 0.063), there was a significant relationship between FISS and neurosurgery (p = <0.001). Conclusion. There is a relationship between the severity of maxillofacial trauma based on the Facial Injury Severity Scale (FISS) score on the severity of the head injury.

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P116: Colder, but no less safe: A comparison of bicycle related traumas in winter compared to summer cyclists

CJEM ◽

10.1017/cem.2020.322 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S106-S107

Author(s):

S. Davis ◽

J. Delaney

Keyword(s):

Protective Factor ◽

Injury Severity ◽

Head Injuries ◽

Severity Scale ◽

Chi Square ◽

Helmet Use ◽

Trauma Severity ◽

Significant Difference ◽

Level I ◽

Chi Square Analysis

Introduction: This study aimed to examine difference in trauma injuries between bicycle users in winter months compared to summer months. Behavioral variables were also examined to assess seasonal variability, as well as associations with traumas. Methods: This was a retrospective cohort study of all bicycle related traumas presenting to a level I trauma center between the years 1998-2018. All data was collected through a standardized trauma database. Seasonal differences were examined by comparing trauma severity and behavior patterns between patients arriving in the months May-September (summer) and those arriving in November-March (winter). Outcome measures included: Injury Severity Scale, GCS, type of accident, helmet use, demographics and alcohol level. Groups were compared using t-tests and Chi-square analysis as appropriate. Results: A total of 980 bicycle related traumas were analyzed. There were a significantly greater number of injuries in the summer as compared to winter months (879 in summer vs. 101 in winter). While most injuries in both groups were rated in the severe range of the Injury Severity Scale, there were no differences in injury severity, initial GCS, deaths, or head injuries between the two seasons. There were also no differences in drug, alcohol, or helmet use. The only significant difference between seasons was that winter riders were more likely to be male. Overall, helmet use was associated with lower injury severity, less head trauma, and a higher initial GCS. Use of alcohol was associated with less likelihood of wearing a helmet. Conclusion: In conclusion, bicycle use in winter does not appear to be associated with worse outcomes than summer. Public health interventions can continue to encourage winter bicycle use, with the encouragement of helmet use and avoidance of alcohol when cycling as an important protective factor in both seasons.

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Application of a Facial Injury Severity Scale in Craniomaxillofacial Trauma

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2005.11.013 ◽

2006 ◽

Vol 64 (3) ◽

pp. 408-414 ◽

Cited By ~ 78

Author(s):

Shahrokh C. Bagheri ◽

Eric J. Dierks ◽

Deepak Kademani ◽

Eric Holmgren ◽

R. Bryan Bell ◽

...

Keyword(s):

Injury Severity ◽

Facial Injury ◽

Severity Scale ◽

Craniomaxillofacial Trauma

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КЛІНІКО-АНАТОМІЧНІ ОСОБЛИВОСТІ ПЕРЕЛОМІВ ВЕРХНЬОЇ ЩЕЛЕПИ У ПАЦІЄНТІВ ІЗ РІЗНИМ ТИПОМ ЇЇ ПНЕВМАТИЗАЦІЇ

Scientific and practical journal "Stomatological Bulletin" ◽

10.35220/2078-8916-2021-39-1-36-47 ◽

2021 ◽

Vol 114 (1) ◽

pp. 36-47

Author(s):

Є. В. Шуминський ◽

А. В. Копчак

Keyword(s):

Injury Severity ◽

Facial Injury ◽

Severity Scale

Індивідуальна анатомія кісток середньої зони облич-чя (КСЗО) позначається на особливостях їх руйну-вання та ускладнює процес лікування та реабілітації пацієнтів із травматичними переломами.Мета. Вивчення взаємозв’язків між клініко-рентгенологічними характеристиками переломів вер-хньої щелепи (ВЩ) та особливостями її будови, зок-рема ступенем пневматизації.Матеріали і методи. Проаналізовано та порівняно значення кількості щілин переломів, кількості улам-ків, частоту утворення дефектів на ділянках контр-форсів, показник Facial Injury Severity Scale у пацієн-тів із різним значенням індексу пневматизації (ІП).Результати. Пневматичний тип будови КСЗО хара-ктеризується збільшенням ступеня фрагментації та утворенням дефектів контрфорсів ВЩ у порівнянні з нормальним типом будови (66 % та 58 % відповідно, р>0,999).Висновки. Характеристики переломів ВЩ залежать від особливостей її архітектоніки, а саме від ІП, що необхідно враховувати при плануванні лікувальних заходів.

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