Pediatric facial trauma: how social determinants of health impact injury patterns

Abstract

Objective

To evaluate social determinants of health and pediatric facial trauma and characterize pediatric facial trauma.

Study design

Retrospective observational cohort.

Setting

Tertiary pediatric hospital.

Methods

Review of patients <18 years seen for facial trauma from 2016 to 2022.

Results

10,227 patients presented with facial trauma (median age 4.97 years, 62.2 % male). Lacerations represented 83.3 % (n = 8523) of facial traumas and were found in younger patients (median age 4.72 years), followed by bony trauma (15.0 %, n = 1531) which was found in older patients (median age 10.6 years). Mechanism of injury was available for 5523 patients, with 72.1 % due to motor vehicle collision (MVC, n = 3981), 18.2 % due to dog bite (n = 1007), and 4.85 % from gunshot wounds (GSW, n = 268). MVCs were positively associated with female sex (OR 1.15, p < 0.001), Black race (OR 1.35, p < 0.001), and older age (p < 0.001). Dog bites were positively associated with White race (OR 3.77, p < 0.001), Hispanic/Latino ethnicity (OR 1.22, p < 0.001), and younger age (p < 0.001). GSW patients were older (p < 0.001) and were three times more likely to be male (OR 3.15, p < 0.001) and Black (OR 2.87, p < 0.001).

Conclusion

To our knowledge, the present study includes the largest single-institution review of pediatric facial trauma and highlights differences from adult populations. The most common mechanisms of injury were MVC, dog bites and GSWs. Age, race, ethnicity and insurance played significant, but varying roles in patterns of trauma. The sociodemographic factors associated with facial trauma are important considerations for public health efforts in reducing risk for pediatric trauma.