Epidemiology of Craniofacial Injuries in a Tertiary University Hospital in Tehran, ۲۰۱۳-۱۴

Background: Craniofacial injuries are a major cause of trauma-related disability and damage. Knowledge of the common causes of injuries to the head and facial areas and the resulting effects on the bone structures or brain tissue will be useful for healthcare personnel. Objectives: The aim was to investigate the common causes of injuries in patients with craniofacial trauma, and to describe the resulting bone and soft tissue injuries. Methods: In this one-year cross-sectional study (۲۰۱۳ - ۱۴) which was carried out in a tertiary referral hospital, ۴۱۶ patients who suffered from various forms of craniofacial traumatic injuries (resulting from traffic accidents, assaults, falls, etc.) were enrolled in the study on a consecutive basis. Their medical records and radiographs were examined, and interviews were conducted with the patients and their family members to determine the exact causes of the injuries. Results: Of the ۴۱۶ cases, ۳۵۶ were males (۸۵.۶%). Mean (SD) age was ۳۳.۱ (۲۱.۱) years. The most common cause of injury was falls (۱۳۷ cases, ۳۲.۹%) followed by motorcycle accidents (۸۶ cases, ۲۰.۷%). Of the ۲۰۶ patients with skull fractures (۴۹.۵% of the sample), ۱۲۵ (۵۸.۴% of the group) were in non-motor vehicle accidents versus ۸۱ patients (۴۰.۱%) who were in the motor vehicle accident group (P < ۰.۰۰۰۱). Facial bone fractures were more common among those with non-motor vehicle accident injuries (۲۸.۵%) versus those who had been in motor vehicle accidents (۱۲.۴%, P < ۰.۰۰۰۱). Conversely, intracranial hemorrhage (۷۴.۳% vs. ۵۸.۹%, P = ۰.۰۰۱) and brain tissue injuries including a contusion, edema, herniation, or burst lobe (۴۴.۶% vs. ۲۴.۸%, P < ۰.۰۰۰۱) were respectively more prevalent in motor vehicle accident traumas than in non-vehicle motor accident injuries. At follow-up, ۳۴ patients had died during hospitalization, ۶۹ patients had undergone cranial surgery, and ۶۷ required facial surgery. Conclusions: Craniofacial injuries were more common in males in their thirties, with falls and motorcycle accidents as the most common causes. In motor vehicle accidents, we observed a significantly higher proportion of intracranial hemorrhages and brain tissue injuries. In non-motor vehicle accidents (including falls, assaults, accidentally hitting the head/face with a sharp/hard object, etc.), skull/facial bone fractures were more common. These findings can be considered by clinicians as well as forensic medicine specialists