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Stanbouly D, Stewart SJ, Harris JA, Arce K. Does Alcohol Use Influence Hospitalization Outcomes in Adults Suffering Craniomaxillofacial Fractures From Street Fighting? Craniomaxillofac Trauma Reconstr 2024; 17:132-142. [PMID: 38779398 PMCID: PMC11107825 DOI: 10.1177/19433875231164705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Study Design This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the corresponding ICD-10 codes. Objective To determine whether alcohol use (measured by blood alcohol content (BAC)) in patients sustaining maxillofacial trauma from hand-to-hand fighting influence hospitalization outcomes. Methods The primary predictor variable was BAC stratified into six categories of increasing magnitude. The primary outcome variable was mean length of hospital stay (days). The secondary outcome variable was total hospital charges (US dollars). Results Our final sample consisted of 3038 craniomaxillofacial fractures. Each additional year in age added +$545 in hospital charges (P < .01). Non-elective admissions added $14 210 in hospital charges (P < .05). Patients admitted in 2018 experienced approximately $7537 more in hospital charges (P < .01). Le Fort fractures (+$61 921; P < .01), mandible fractures (+$13 227, P < .01), and skull base fractures (+$22 170; P < .05) were all independently associated with increased hospital charges. Skull base fractures added +7.6 days to the hospital stay (P < .01) and each additional year in patient age added +.1 days to the length of the hospital stay (P < .01). Conclusions BAC levels did not increase length of stay or hospitalization charges. Le Fort fractures, mandible fractures, and skull base fracture each independently increased hospital charges. This reflects the necessary care (ie, ICU) and treatment (ie, ORIF) of such fractures. Older adults and elderly patients are associated with increased length of stay and hospital charges-they are likely to struggle in navigating the healthcare system and face socioeconomic barriers to discharge.
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Affiliation(s)
- Dani Stanbouly
- Columbia University College of Dental Medicine, New York, NY, USA
| | - Sara J. Stewart
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Kevin Arce
- Division of Oral and Maxillofacial Surgery, Section of Head and Neck Oncologic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
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Rivis M, Juncar RI, Moca AE, Moca RT, Juncar M, Țenț PA. Patterns of Mandibular Fractures through Human Aggression: A 10-Year Cross-Sectional Cohort Retrospective Study. J Clin Med 2023; 12:4103. [PMID: 37373796 DOI: 10.3390/jcm12124103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/10/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The World Health Organization considers the victims of interpersonal violence to be a medical priority. In order to provide services at the highest level, we aimed to evaluate the patterns of maxillofacial fractures caused by interpersonal violence, in order to treat, counsel and guide these patients. This retrospective study was conducted in 478 patients with mandibular fractures caused by interpersonal violence over 10 years in a university clinic. The most affected were male patients (95.19%), 20-29 years of age (46.86%), under the influence of alcohol (83.26%) and without education (43.9%). The majority of mandibular fractures were displaced (89.3%) and intraorally open (64.0%). The most frequent location was the mandibular angle (34.84%). The most frequent soft tissue lesions were hematomas (45.04%) and abrasions (34.71%), being associated frequently with closed (p = 0.945/p = 0.237), displaced (p = 0.001/p = 0.002), single angle fractures (p = 0.081/p = 0.222). Educating the population and fighting alcohol consumption would decrease the occurrence of mandibular fractures through aggression. Clinical diagnosis should be made, keeping in mind that the severity of associated soft tissue lesions is directly proportional to the pattern and number of underlying fracture lines.
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Affiliation(s)
- Mircea Rivis
- Discipline of Oral Surgery, 2nd Department of Dental Medicine, "Victor Babeș" University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 30041 Timișoara, Romania
| | - Raluca Iulia Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Rahela Tabita Moca
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania
| | - Mihai Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Paul Andrei Țenț
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
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Jin R, Georges K, Jasti S, Ahsanuddin S, Cadwell JB, Paskhover B. Impact of Age on Surgical Outcomes Following Mandible Fracture Repair. Laryngoscope 2023; 133:287-293. [PMID: 35638520 DOI: 10.1002/lary.30208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/07/2022] [Accepted: 04/25/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Open repair of mandibular fractures are frequently performed surgical procedures. Increasing rates of such fractures are seen in older adults following falls. This study assesses the impact of older age on early complications following mandible fracture repair. STUDY DESIGN Retrospective analysis of national registry. METHODS The 2013-2018 National Surgical Quality Improvement Program database was queried for all cases of open mandible fracture repair and cases were categorized into younger (18-40), middle (41-65), and older (>65) age cohorts. Demographics and comorbidities were compared between the age groups. Rates of surgical, medical, and wound complications within 30-days of surgery were determined. Multivariable logistic analyses were performed to assess the relationship between age and complications. RESULTS Altogether, 1818 cases were included for analysis, of which 1269 (69.8%) were younger, 459 (25.2%) were middle, and 90 (5.0%) were older age. Increased rates of complications were seen in the older groups, including unplanned reoperation, unplanned readmission, wound disruption, and medical complications (p < 0.01). On unadjusted analysis, the older (>65) age group had an increased odds of experiencing a complication compared to the younger (18-40) group (OR: 4.19, p < 0.001). The older age group continued to have a significantly increased odds of medical complications after multivariable adjustment (adjusted OR: 8.64, p < 0.001). CONCLUSIONS On this analysis of a national database, advanced age was associated with an increased frequency of early postoperative complications following open mandibular fracture repair. Following multivariable adjustment, advanced age continued to be associated with increased odds of postoperative medical complications within 30 days of surgery. LEVEL OF EVIDENCE 3 Laryngoscope, 133:287-293, 2023.
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Affiliation(s)
- Ryan Jin
- Department of Otolaryngology, Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Kirolos Georges
- Department of Otolaryngology, Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Shravya Jasti
- Department of Otolaryngology, Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Salma Ahsanuddin
- Department of Otolaryngology, Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Joshua B Cadwell
- Department of Otolaryngology, Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Boris Paskhover
- Department of Otolaryngology, Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Recurrent mandibular fractures: a retrospective study over 17 years on aetiology, demographics, fracture patterns, and management. Int J Oral Maxillofac Surg 2021; 50:1596-1602. [PMID: 34074576 DOI: 10.1016/j.ijom.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 11/23/2022]
Abstract
Recurrent fractures of the mandible are rare, however in Darwin, Australia, their occurrence is relatively frequent. This retrospective study identified 127 patients with 148 recurrent mandibular fractures treated at Royal Darwin Hospital between 2000 and 2017. Age, sex, ethnicity, marital status, aetiology, risk factors, anatomical location of the fractures, fracture patterns, and management of the fractures were analysed. The majority of patients were male (85.8%) (P < 0.001); 62.8% were unmarried (P < 0.001) and 72.4% were indigenous (P < 0.001). Alcohol was involved in 79.1% of cases (P < 0.001) and assault was the most common mechanism of injury (84.5%) (P < 0.001). The angle of the mandible was the most common site (P < 0.001), and recurrent fractures were more likely to occur at sites different to a previous fracture fixation site (P < 0.001). Smoking, alcohol abuse, and diabetes were strongly associated with recurrent fractures (all P < 0.001). Most patients were managed with open reduction internal fixation. In conclusion, recurrent fractures of the mandible frequently involved the angle of the mandible and occurred at different sites. Their incidence was more common among the unmarried, male, and indigenous population, and smoking, alcohol abuse, and diabetes were found to be significant risk factors.
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Hino S, Yamada M, Iijima Y, Araki R, Kaneko T, Horie N. Effects of alcohol consumption on maxillofacial fractures in simple falls. Clin Exp Dent Res 2020; 6:544-549. [PMID: 32720445 PMCID: PMC7545223 DOI: 10.1002/cre2.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/18/2020] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to investigate the effects of alcohol consumption (AC) on maxillofacial fractures caused by falls on a level surface (simple falls). Material and Methods Patients with maxillofacial fractures caused by falls who visited the Oral and Maxillofacial Surgery Clinic from January 2006 to December 2016 were evaluated. Patients with simple falls were subdivided into those who fell with AC (Falls with AC) and those who fell without AC (Falls without AC). Results Of 180 patients with falls with maxillofacial fractures, 155 had simple falls, and 25 patients had falls from a height. Of the simple falls, 52 were Falls with AC, and 102 were Falls without AC. Falls with AC were significantly more frequent in males (p = .0005). The average number of fracture lines in the mandible was significantly higher in Falls with AC (2.13 ± 0.99 [mean ± SD]) than in Falls without AC (1.76 ± 0.91) (p = .011). The average Facial Injury Severity Scale was significantly higher in Falls with AC (3.08 ± 1.43) than in Falls without AC (2.43 ± 1.29) (p = .007). Conclusions Falls with AC were associated with more severe maxillofacial fractures than Falls without AC.
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Affiliation(s)
- Shunsuke Hino
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Miki Yamada
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yosuke Iijima
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Ryuichiro Araki
- Community Health Science Center, Saitama Medical University, Saitama, Japan
| | - Takahiro Kaneko
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Norio Horie
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Nishimoto RN, Dodson TB, Lang MS. Is the Mandible Injury Severity Score a Valid Measure of Mandibular Injury Severity? J Oral Maxillofac Surg 2019; 77:1023-1030. [DOI: 10.1016/j.joms.2018.11.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 11/26/2022]
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Hino S, Yamada M, Araki R, Kaneko T, Horie N. Effects of loss of consciousness on maxillofacial fractures in simple falls. Dent Traumatol 2018; 35:48-53. [PMID: 30402998 DOI: 10.1111/edt.12452] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIMS Loss of consciousness while falling is reported to increase the risk of more severe injury. However, few studies of maxillofacial injuries have been reported. The aim of this study was to investigate the effects of loss of consciousness on maxillofacial fractures in falls on a level surface (simple falls). MATERIAL AND METHODS Patients with maxillofacial fractures caused by simple falls were subdivided into two categories: patients who fell without loss of consciousness and patients who fell with loss of consciousness, according to the Guidelines for the Diagnosis and Management of Syncope (version 2009). The severity of the injuries was compared between these two groups. RESULTS In 413 patients with maxillofacial fractures, 58 cases were falls without loss of consciousness, and 44 cases were falls with loss of consciousness. In falls with loss of consciousness, 54.5% were reflex syncope, followed by syncope due to orthostatic hypotension (15.9%), epilepsy (15.9%), and cardiac syncope (9.1%). The average number of fracture lines in the mandible was significantly lower in falls without loss of consciousness (1.53 ± 0.7) than in falls with loss of consciousness (2.00 ± 1.00) (P = 0.045). The average Facial Injury Severity Scale score was lower in falls without loss of consciousness (2.24 ± 1.20) than in falls with loss of consciousness (2.68 ± 1.39). Fractures of other parts of the body were significantly more common in falls without loss of consciousness (22.2%) than in falls with loss of consciousness (9.1%) (P = 0.0135). CONCLUSIONS Patients with loss of consciousness and maxillofacial fractures due to simple falls showed a tendency to sustain more severe maxillofacial injuries than those without loss of consciousness.
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Affiliation(s)
- Shunsuke Hino
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Miki Yamada
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Ryuichiro Araki
- Community Health Science Center, Saitama Medical University, Saitama, Japan
| | - Takahiro Kaneko
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Norio Horie
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Lee KH, Qiu M, Sun J. Temporal distribution of alcohol related facial fractures. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:450-455. [DOI: 10.1016/j.oooo.2017.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022]
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Kruger E, Tennant M. Socioeconomic disadvantage and oral-health-related hospital admissions: a 10-year analysis. BDJ Open 2016; 2:16004. [PMID: 29607065 PMCID: PMC5842864 DOI: 10.1038/bdjopen.2016.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/16/2016] [Indexed: 11/28/2022] Open
Abstract
Objective: The aim of this Western Australian population study was to assess the relationship of socioeconomic disadvantage and: 1) trends in hospitalisations for oral-health-related conditions over 10 years; 2) insurance status, costs and length of stay in hospital; and 3) specific conditions (principal diagnosis) patients were admitted for. Methods: Hospitalisation data (of oral-health-related conditions) were obtained for every episode of discharge from all hospitals in Western Australia for the financial years 1999–2000 to 2008–2009. Area based measures (using the Index of Relative Socioeconomic Disadvantage) was used to determine relationships between socioeconomic status and other variables. Results: The most disadvantaged in the population are being hospitalised at significantly higher rates than other groups, stay in hospital for longer, and at higher costs. This trend remained over a period of 10 years. Those least disadvantaged have the second highest rates of hospitalisation, but the likelihood of being admitted for different procedures differ between these two extremes. Conclusions: The importance of socioeconomic determinants of health are evident when analysing these hospitalisations. Recognition that lifestyle choices are severely restricted among the most marginalised and disadvantaged groups in the population can no longer be ignored in attempts to reduce health inequalities.
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Affiliation(s)
- Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, Faculty of Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, Faculty of Sciences, The University of Western Australia, Nedlands, WA, Australia
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Krishnan B. The Role of a Conservative Minimal Interventional Management Protocol in the Fractures of the Dentate Portion of the Adult Mandible. Craniomaxillofac Trauma Reconstr 2016; 9:20-8. [PMID: 26889344 DOI: 10.1055/s-0035-1556050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 01/21/2015] [Indexed: 01/08/2023] Open
Abstract
Mandibular fractures are commonly encountered by the maxillofacial surgeon. Maxillomandibular fixation (MMF) and open reduction and internal fixation (ORIF), or a combination of both, are the accepted standard treatments. This study aims to assess the role of a conservative minimal intervention protocol in the management of undisplaced/minimally displaced fractures of the dentate portion of the adult mandible and the complications associated with such minimalistic intervention. Thirty-four patients with undisplaced/minimally displaced fractures of the dentate portion of the adult mandible were advised to restrict mouth opening and limit themselves to a soft diet for a minimum of 4 weeks. All patients were advised follow-up at regular intervals for at least 3 months. Five patients were lost to follow-up. Symphysis and parasymphysis fractures were the most common fracture locations. Fourteen patients needed tension band stabilization with a mandibular arch bar/bridle wiring and three patients required extraction of luxated teeth. All patients showed satisfactory healing except three in whom additional intervention (ORIF) was performed. The improvement in mouth opening was statistically significant. Complications were seen more frequently among smokers and alcoholics. For patients with minimally displaced mandibular fractures, it is necessary to consider if the perceived benefits of intervention justify the associated added costs and possible complications. Patients have to be fully informed about the possible complications while using this minimal intervention protocol. This study concludes that a conservative minimal intervention management protocol for such fractures of the dentate portion of the mandible can produce satisfactory results.
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Affiliation(s)
- Balasubramanian Krishnan
- Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
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12
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Abstract
BACKGROUND Previous analysis of jaw fracture hospitalisations in Western Australia (WA) indicated disproportionately high rates of hospitalisations for Aboriginal people. This study was to follow-up on the earlier analysis to determine if inequalities in terms of jaw fracture hospitalisation rates between Aboriginal and non-Aboriginal people have changed. AIMS This study, done over a 10-year period from 1999/2000 to 2008/2009, aimed to determine rates of hospitalisations for jaw fractures in WA, trends over the 10-year period, and direct costs associated with these hospital admissions. METHODS Hospitalisation data were obtained from the Western Australian Hospital Morbidity Data System (HMDS). Episodes were selected on the basis of an ICD10-AM code being S02.4 (Fracture of the malar and maxillary bones) and S02.6 (Fracture of the mandible). Self-reported Aboriginality were used to compare Aboriginal to non-Aboriginal populations. Estimated cost of care was determined for each episode using the national standard diagnostic-related group (DRG) average price. RESULTS Our findings indicate that inequalities between Aboriginal and non-Aboriginal people in terms of hospital admissions for jaw fractures exist in WA, and continued over a decade-long period. Higher fracture rates occurred amongst males, Aboriginal people, younger adult age-groups, those from low socioeconomic areas, and those from remote and very remote areas. The DRG cost per person for jaw fractures ranged between AUD $842 and $109,002, with a median cost of $4,965. CONCLUSION Hospital admission rates for the treatment of maxillary and mandibular fractures is very strongly divided along racial and socioeconomic lines in WA.
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Affiliation(s)
- Estie Kruger
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The Unversity of Western Australia, Nedlands, WA, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The Unversity of Western Australia, Nedlands, WA, Australia
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Stein MD, Risi MM, Flori JN, Conti MT, Anderson BJ, Bailey GL. Gender Differences in the Life Concerns of Persons Seeking Alcohol Detoxification. J Subst Abuse Treat 2016; 63:34-8. [PMID: 26810131 DOI: 10.1016/j.jsat.2015.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study explored the life concerns of persons seeking alcohol detoxification, a group with multiple life and psychosocial challenges. Gender may be an important contributor to the particular life concerns of persons with alcohol use disorders. METHODS Using a 32-item, previously-validated life concerns survey that captures ten conceptual domains, we interviewed persons entering inpatient alcohol detoxification asking them to rate their level of concern about health and welfare items. RESULTS Participants (n=189) were 27% female, with a mean age of 43.5 years. Overall, concern about alcohol problems was perceived as the most serious, followed by mental health, cigarette smoking, financial, and relationship problems. Men were significantly more concerned than women about six of the ten domains including money, drug use, transmissible diseases, and physical illness. CONCLUSIONS Recognition of the daily worries of persons seeking inpatient alcohol detoxification persons could allow providers to better tailor their services to the context of their patients' lives. Focusing on pressing life concerns such as mental health, financial, relationship problems, and other drug use may influence detoxification services and aftercare treatment choices.
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Affiliation(s)
- Michael D Stein
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906; Warren Alpert Medical School of Brown University, Providence, RI 02912.
| | - Megan M Risi
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906
| | - Jessica N Flori
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906
| | - Micah T Conti
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906
| | | | - Genie L Bailey
- Warren Alpert Medical School of Brown University, Providence, RI 02912; Stanley Street Treatment and Resources, Inc., Fall River, MA 02720
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Abstract
Mandibular fractures are among the most common trauma injuries of the craniomaxillofacial region. This study evaluated the late results of mandibles fractures treated with arch bar. Forty-nine patients were examined clinically and by questionnaires for late results of arch bar treatment. Demographic data (age, sex, etc), trigeminal nerve sensation (Weber test), temporomandibular joint evaluation, masticatory muscle function, and occlusion were recorded. The data were analyzed by χ test using Sigma Stat 2.0 software. Fifty-one percent of the patients with angular fractures complained of sensory disturbances. Condylar and angular fractures demonstrated higher levels of pain. According to Pearson χ test, a statistically significant relation between angular fracture and tenderness of the internal pterygoid muscles (P = 0.047), angular fracture and cross-bite (P = 0.021), parasymphysial fracture and pain upon wind blowing (P = 0.026), and body fracture and mastication discomfort (P = 0.038) was found. In closed reduction therapy, fracture location of the mandible seems to be more likely correlated in producing particular long-term complications. Regular follow-ups for functional treatments and physiotherapy of chewing muscles and temporomandibular joint, along with removal of occlusal abnormalities, should be considered following arch bar reduction of mandibular fractures.
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Jung HW, Lee BS, Kwon YD, Choi BJ, Lee JW, Lee HW, Moon CS, Ohe JY. Retrospective clinical study of mandible fractures. J Korean Assoc Oral Maxillofac Surg 2014; 40:21-6. [PMID: 24627839 PMCID: PMC3949494 DOI: 10.5125/jkaoms.2014.40.1.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 01/20/2014] [Accepted: 01/28/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of mandible fractures that were treated by the Department of Oral and Maxillofacial Surgery in Kyung Hee University Dental Hospital from January 2002 to December 2012. Materials and Methods This was a descriptive and analytic retrospective study that evaluated 735 patients that were treated for mandible fracture. Results This study included 1,172 fractures in 735 patients. The ratio of male to female patients was 5.45 : 1; the maximum value was in patients between 20 and 29 years (38.1%) and the minimum in patients over 70 years old. The monthly distribution of facial fractures peaked in the fall and was lower during winter. No specific correlation was identified based on the annual fracture distribution. Among the 735 fracture patients, 1.59 fracture lines were observed per patient. The most frequent site was the symphysis, which accounted for a total of 431 fractures, followed by the angle (348), condyle (279), and body (95). The symphysis with angle was the most common site identified in combination with fracture and accounted for 22.4%, followed by symphysis with condyle (19.8%). The angle was the most frequent site of single fractures (20.8%). The major cause of injury was accidental trauma (43.4%), which was followed by other causes such as violence (33.9%), sports-related accidents (10.5%), and traffic accidents (10.1%). Fracture incidents correlated with alcohol consumption were reported between 10.0%-26.9% annually. Conclusion Although mandible fracture pattern is similar to the previous researches, there is some changes in the etiologic factors.
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Affiliation(s)
- Hai-Won Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Baek-Soo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Byung-Jun Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Hyun-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Chang-Sig Moon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
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