South Australian facial trauma: a population analysis of social economic deprivation and facial fractures—part one

Abstract

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 f ractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. 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 f rom plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted f rom 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 f racture. 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 f ractures were the most common type of facial f racture (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 f racture and likelihood of surgery with the most disadvantaged having higher rates compared to the least disadvantaged.