Traumatic brain injury in patients with facial fracture - a challenge for the clinician?

IF 2.2 3区医学 Q2 Dentistry Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-02-21 DOI:10.1016/j.jormas.2025.102302

L Kokko, T Puolakkainen, H Thorén, A Piippo-Karjalainen, A L Suominen, J Snäll

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引用次数: 0

Abstract

Objective: This study aimed to evaluate the occurrence and clinical predictors for missed traumatic brain injury (TBI) diagnosis at primary evaluation in facial fracture patients. The specific aim was to compare the risk between adults and elderly patients.

Materials and methods: A retrospective study was performed, and data were collected from medical records. All adult facial fracture patients with associated TBI and a primary Glasgow Coma Scale score of 13 or more diagnosed and treated between 2013 and 2018 were included. The elderly group comprised patients aged at least 65 years at the time of injury.

Results: Altogether 253 patients with facial fracture and associated TBI were assessed. In 7.1% of the cases, the diagnosis of TBI was missed in primary evaluation and thus delayed. When the different age groups were compared, the elderly had a 2.8-fold risk of missed TBI diagnosis (95% CI 1.1-7.2, p=.0349).

Conclusions: Facial fracture patients are at significant risk of the diagnosis of associated TBI being missed at primary evaluation. Especially elderly patients with other than high-energy trauma mechanism, such as falling on ground level, are at risk of missed TBI diagnosis. Thus, patients with facial fracture should be carefully evaluated to exclude potential TBI. Assessment should occur in trauma centres where multiprofessional evaluation of these patients is routine.

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来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.