Sobering Overview of Traumatic Craniofacial Injuries Involving Drugs and Alcohol: A Comprehensive Analysis of the NEISS Database

The purpose of this study is to provide a comprehensive overview of the epidemiology of traumatic craniofacial injuries in the U.S. that occur in the context of drugs and/or alcohol. The National Electronic Injury and Surveillance System (NEISS) database was queried from 2019 to 2022 to identify all emergency department (ED) patients with reported traumatic injuries involving craniofacial anatomy. Clinical and demographic variables were assessed between cases that involved drugs/alcohol and those that did not, utilizing two-proportion z-tests. In total, 441,764 patients with traumatic craniofacial injuries were identified, with 20,285 cases involving drugs and/or alcohol. Cases involving drugs/alcohol had a significantly higher frequency of internal injuries (45.3% vs. 34.9%, <i>p</i> < 0.001), fractures (7.0% vs. 3.4%, <i>p</i> < 0.001), and hematomas (4.6% vs. 2.5%, <i>p</i> < 0.001) than those that did not. Craniofacial injuries involving drugs/alcohol also had a significantly higher frequency of falls to the floor (19.2% vs. 11.8%, <i>p</i> < 0.001) and down stairs/steps (18.3% vs. 6.6%, <i>p</i> < 0.001) and resulted in a significantly greater odds of hospital admission after ED presentation (OR 3.75, 95% CI: 3.63-3.88, <i>p</i> < 0.001). Ultimately, these epidemiological findings can be leveraged to provide clinicians invaluable qualitative context for the most frequent presentations of craniofacial injuries they can anticipate to treat among intoxicated patients.