Epidemiological Survey of Head and Neck Injuries and Trauma in the United States

Objective Head and neck trauma results in a range of injuries, spanning minor lacerations to life-threatening airway compromise. Few studies provide in-depth analysis of injuries to the head and neck (HN). We aim to (1) describe HN injury prevalence in the US and (2) investigate patient disposition and the outcome of mortality. Study Design Case series with chart review. Setting Nationwide emergency department (ED) sample. Methods The 2011 database was queried for encounters with a primary diagnosis of HN injury, as categorized by the Barell Injury Matrix. Weighted estimates for demographics, injury category, and mechanism were extracted. Predictors of mortality and admission were determined by multivariable regression. Results We identified 131 million ED encounters. A weighted total of 5,418,539 visits were related to primary HN injuries. Average age was 30 (SE = 0.4), and 56.8% were male. Sixty-four percent of injuries were attributed to fall or blunt trauma. Open wounds comprised 41.8% of injuries. The most common procedure was laceration repair (70%). The majority of patients (97%) were discharged home. Mortality rate was less than 1%. Predictors of admission and mortality (P < .05) included multiple trauma, vessel trauma, and burns. Other risk factors included foreign-body, older age, and male gender. Conclusions Primary HN injuries commonly present to emergency rooms in the US. The majority of HN injuries are non–life threatening and do not require admission to the hospital or result in death. These data have implications for HN injury surveillance and may be used to risk-stratify patients who present with injuries in the acute care setting.

[1]  E Zaloshnja,et al.  Incidence and lifetime costs of injuries in the United States , 2006, Injury Prevention.

[2]  V. Allareddy,et al.  Impact of facial fractures and intracranial injuries on hospitalization outcomes following firearm injuries. , 2014, JAMA otolaryngology-- head & neck surgery.

[3]  Cecelia E Schmalbach,et al.  The Otolaryngologist’s Cost in Treating Facial Trauma , 2012, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[4]  V. Allareddy,et al.  Epidemiology of facial fracture injuries. , 2011, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[5]  M. Schreiber,et al.  Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the Surgery of Trauma. , 2010, The Journal of trauma.

[6]  L. Cancio Airway management and smoke inhalation injury in the burn patient. , 2009, Clinics in plastic surgery.

[7]  N. Yoganandan,et al.  Facial fractures in motor vehicle collisions: epidemiological trends and risk factors. , 2009, Archives of facial plastic surgery.

[8]  G. Witt Race and Insurance Status as Risk Factors for Trauma Mortality , 2009 .

[9]  A. Bener,et al.  Incidence and severity of head and neck injuries in victims of road traffic crashes: In an economically developed country. , 2009, International emergency nursing.

[10]  F. Rivara,et al.  Patterns and outcomes of pediatric facial fractures in the United States: a survey of the National Trauma Data Bank. , 2008, Journal of the American College of Surgeons.

[11]  P. Rhee,et al.  Clinical practice guideline: penetrating zone II neck trauma. , 2008, The Journal of trauma.

[12]  E. Mackenzie,et al.  The National Study on Costs and Outcomes of Trauma. , 2007, The Journal of trauma.

[13]  Julia Seifert,et al.  Incidence and economic burden of injuries in the United States , 2007, Journal of Epidemiology & Community Health.

[14]  Michael R Galarneau,et al.  Head, face, and neck injuries during Operation Iraqi Freedom II: results from the US Navy-Marine Corps Combat Trauma Registry. , 2007, The Journal of trauma.

[15]  M. Karbakhsh,et al.  Epidemiology study of facial injuries during a 13 month of trauma registry in Tehran. , 2004, Indian journal of medical sciences.

[16]  M. Kumar,et al.  Head and Neck Trauma in Hospitalized Pediatric Patients , 2004, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[17]  W. Hauser,et al.  The Epidemiology of Traumatic Brain Injury: A Review , 2003, Epilepsia.

[18]  T. Tuli,et al.  Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. , 2003, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[19]  A. Ziv,et al.  An introduction to the Barell body region by nature of injury diagnosis matrix , 2002, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[20]  R. Rutledge,et al.  External laryngeal trauma analysis of 392 patients. , 1999, Archives of otolaryngology--head & neck surgery.

[21]  G. Westman,et al.  Gender patterns in minor head and neck injuries: an analysis of casualty register data. , 1996, Accident; analysis and prevention.

[22]  A. Sauaia,et al.  Epidemiology of trauma deaths: a reassessment. , 1993, The Journal of trauma.

[23]  H. Champion,et al.  Leading causes of facial trauma in the major trauma outcome study. , 1995, Plastic and reconstructive surgery.

[24]  I. Jackson,et al.  A comprehensive analysis of craniofacial trauma. , 1994, The Journal of trauma.

[25]  T. Fabian,et al.  Penetrating neck injuries: recommendations for selective management. , 1989, The Journal of trauma.

[26]  D. Demetriades,et al.  Carotid artery injuries: experience with 124 cases. , 1989, The Journal of trauma.

[27]  W. F. Wagner,et al.  The epidemiology of facial fractures. , 1978, The Journal of the Kentucky Medical Association.