Temporal trends in admission volume of midface fractures depending on mechanism of injury in the United States.

Abstract

Midface fractures are a common reason for facial trauma team consultation and may differ widely in mechanism of injury, severity, and surgical management. We investigated trends in admission-based incidence and cyclic occurrence of midface fractures using a large national database. Admissions associated with midface fractures were identified in the National Inpatient Sample from 2017 to 2022. Trends for admission-based incidence, hospital charge, and time from admission to surgery were calculated across the time period. Moving averages and autocorrelation analyzes were applied to calculate periodicity for different etiologies of fracture, including motor vehicle accidents (MVAs), falls, and assault (p<0.05). The final cohort included 451,260 admissions for midface fractures. The most common mechanism of injury was falls (41.8%), followed by MVAs (29.9%), and assault (11.7%). The year-adjusted admission-based incidence of all midface fractures significantly increased from 1114 to 1522 per 100,000 admissions from 2017 to 2022 (p=0.024). Autocorrelations at a lag of 6 months for the total cohort, MVAs, and assault were significantly negative, indicating a cyclic periodicity between opposite times of the year. Moving averages for median hospital charge and mean time from admission to surgery increased significantly over time (p<0.001). The volume and economic burden of midface fractures is growing nationally, which may be associated with corresponding increases in MVAs and falls. The cyclic occurrence of midface fractures may be correlated with increased MVAs during the summer months. These findings may better inform public health efforts and facial trauma team resource allocation.