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

Main Article Content

Jason Diab
Benjamin Grave
Walter Flapper
Peter Anderson
David J David
Mark Moore

Keywords

trauma, facial injuries, social class, inequalities, regestries

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 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.




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References

1. Australian Institute of Health and Welfare, Henley G, Harrison JE. Injury mortality and socioeconomic influence in Australia, 2015-16, injury research and statistics series no. 128. cat. no. INJCAT 208 [PDF on Internet]. Canberra: Commonwealth of Australia. [Published 2019; cited September 2020]. Available from: https://www.aihw.gov.au/getmedia/1e03d183-8b8f-4037-b4a4-e576bb22a9b0/aihw-injcat-208.pdf.aspx?inline=true.
2. Hanna CL, Laflamme L, Bingham CR. Fatal crash involvement of unlicensed young drivers: county level differences according to material deprivation and urbanicity in the United States. Accid Anal Prev. 2012;45:291–95. https://doi.org/10.1016/j.aap.2011.07.014. PMid:22269512
3. Burrows S, Auger N, Gamache P, Hamel D. Individual and area socioeconomic inequalities in cause-specific unintentional injury mortality: 11-year follow-up study of 2.7 million Canadians. Accid Anal Prev. 2012;45:99–106. https://doi.org/10.1016/j.aap.2011.11.010. PMid:22269490
4. Birken CS, MacArthur C. Socioeconomic status and injury risk in children. Paediatr Child Health. 2004;9(5):323–25. https://doi.org/10.1093/pch/9.5.323. PMid:19657518 PMCid:PMC2721183
5. Stokes M, Ashby K, Clapperton A. The effect of socio-economic status on injury among Victorians. Hazard. 2001/02;49:2–12. Available from: https://www.monash.edu/__data/assets/pdf_file/0003/218487/haz49.pdf.
6. Willson AE. Fundamental causes of health disparities: a comparative analysis of Canada and the United States. Int Sociol. 2009;24(1):93–113. https://doi.org/10.1177/0268580908099155.
7. Laflamme L, Burrows S, Hasselberg M. Socioeconomic differences in injury risks: a review of findings and a discussion of potential countermeasures [PDF on Internet]. Copenhagen: World Health Organisation Europe. [Published 2009; cited 7 July 2020). Available from: http://www.euro.who.int/__data/assets/pdf_file/0012/111036/E91823.pdf.
8. Australian Bureau of Statistics. Census QuickStats, 2016 [web page]. Canberra: Commonwealth of Australia. [2016; cited 1 July 2020]. Available from: https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/4?opendocument.
9. Snell B, Grave B. The multidisciplinary management of complex facial trauma. Aust J Plast Surg. 2018;1(2):31–32. https://doi.org/10.34239/ajops.v1i2.118.
10. Australian Bureau of Statistics. Information paper: an introduction to socio-economic indexes for areas (SEIFA) 2006, (2039.0) [web report]. Canberra: Commonwealth of Australia. [Updated 26 March 2008; cited September 2020]. Available from: https://www.abs.gov.au/ausstats/[email protected]/mf/2039.0.
11. David DJ, Simpson DA. Craniomaxillofacial trauma: a system of multidisciplinary management by members of the Australian craniofacial unit. Edinburgh: Churchill Livingstone, 1995.
12. Independent Hospital Pricing Authority. National hospital cost data collection report: public sector, round 22, financial year 2017–18 [PDF on Internet]. Sydney: IHPA. [February 2020; cited September 2020]. Available from: https://www.ihpa.gov.au/sites/default/files/round_22_nhcdc_report_public_sector_round_22_2017-18_-_pdf_version.pdf.
13. Australian Institute of Health and Welfare. Australian refined diagnosis-related group (AR-DRG) data cubes 2017–18 [web page]. Canberra: Commonwealth of Australia. [Cited 1July 2020]. Available from: https://www.aihw.gov.au/reports/hospitals/ar-drg-data-cubes/contents/data-cubes.

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