A Demographic Analysis of Craniomaxillofacial Trauma in the Era of COVID-19

Robert C Clark; Bijal Desai; Edward H Davidson

doi:10.1177/19433875211047037

A Demographic Analysis of Craniomaxillofacial Trauma in the Era of COVID-19

Craniomaxillofac Trauma Reconstr. 2022 Dec;15(4):288-294. doi: 10.1177/19433875211047037. Epub 2021 Sep 15.

Authors

Robert C Clark¹, Bijal Desai¹, Edward H Davidson²

Affiliations

¹ Case Western Reserve University School of Medicine, Cleveland, OH, USA.
² Department of Plastic & Reconstructive Surgery, University Hospitals-Case Western Reserve University, Cleveland, OH, USA.

Abstract

Study design: Retrospective cohort study.

Objective: The challenges of COVID-19 could magnify socioeconomic vulnerability for craniomaxillofacial (CMF) trauma. This study compares subjects who presented with CMF fractures to a regional healthcare system during the pandemic with those in 2019. We hypothesized societal circumstances of 2020 would correlate with disproportionately more CMF fractures in vulnerable patients compared to pre-pandemic trends.

Methods: An IRB approved retrospective study of CMF fracture presentations in 2019 and 2020 was performed. Demographics, injury details, and management details were collected. A residence-based poverty index was calculated for each subject utilizing census data. Pre-pandemic and pandemic cases were compared to identify differences between cohorts.

Results: A large decrease in presentations was noted between pre-pandemic and pandemic cohorts. There was significantly greater poverty the pre-pandemic cohort as compared to the pandemic cohort (P = .026). Overall, there was a significant correlation between higher poverty and violent MOI (P < .001). This association was maintained pre-pandemic, (P = .001) but was insignificant in the pandemic cohort (P = .108). Difference between cohorts with respect to violent injury was non-significant (P = .559) with non-significant difference in demographics including age (P = .390), place of injury (P = .136), employment status (P = .905), insurance status (P = .580), marital status (P = .711), ethnicity (P = .068), and gender (P = .656). Management was not significantly different between cohorts including percent hospital admission (P = .396), surgical intervention (P = .120), and time to operation (P = .109).

Conclusions: Contrary to our hypothesis, this analysis indicates that the societal changes brought on by the COVID-19 pandemic did not magnify vulnerable populations. Some changes were noted including in volume of presentation, demographic distribution, and injury detail.

Keywords: COVID-19; craniofacial; demographics; incidence; trauma; vulnerability.