Exploring risk groups for concomitant injuries in facial fracture patients: a data-driven analysis

Abstract Purpose Patients with facial fractures are a diverse group with varying injury mechanisms and extent of injury. These patients often suffer from concomitant injuries (CIs) of different severity outside the facial region, some of which are life-threatening and may require urgent care. Therefore, early identification of patients at risk for CI is important. This study aimed to investigate exploratory risk groups for concomitant injuries in patients with facial fractures, focusing on the impact of injury energy, sex and age on the prevalence and type of concomitant injury. Methods In this retrospective cohort study, a data-driven analysis was used to perform statistical analysis and identify risk groups for different CIs. The study included 4170 patients with facial fractures evaluated at tertiary trauma centres from January 2013 to October 2020. Results 70.9% of patients with facial fractures were male. Patients’ mean age was 45.7 years. Of the injury mechanisms, 36.0% were classified as high-energy trauma. In all, 31.7% of facial fracture patients had some type of CI. Female patients had more CIs than male patients (34.0% vs. 30.8%). The occurrence of CIs increased progressively with age, peaking in the age group 90–94 years, where over 55% of patients experienced CIs. However, considerable variation was observed in CI types across age groups. Conclusion Due to the high CI risk in facial fracture patients, in conjunction with assessment and imaging of the facial trauma, we encourage routinely ruling out CIs, with a special focus on high-risk CI groups.