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Gibson JAG, Dobbs TD, Griffiths R, Song J, Akbari A, Bodger O, Hutchings HA, Lyons RA, John A, Whitaker IS. The association of anxiety disorders and depression with facial scarring: population-based, data linkage, matched cohort analysis of 358 158 patients. BJPsych Open 2023; 9:e212. [PMID: 37964568 PMCID: PMC10753955 DOI: 10.1192/bjo.2023.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/05/2023] [Accepted: 07/18/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Estimates suggest that 1 in 100 people in the UK live with facial scarring. Despite this incidence, psychological support is limited. AIMS The aim of this study was to strengthen the case for improving such support by determining the incidence and risk factors for anxiety and depression disorders in patients with facial scarring. METHOD A matched cohort study was performed. Patients were identified via secondary care data sources, using clinical codes for conditions resulting in facial scarring. A diagnosis of anxiety or depression was determined by linkage with the patient's primary care general practice data. Incidence was calculated per 1000 person-years at risk (PYAR). Logistic regression was used to determine risk factors. RESULTS Between 2009 and 2018, 179 079 patients met the study criteria and were identified as having a facial scar, and matched to 179 079 controls. The incidence of anxiety in the facial scarring group was 10.05 per 1000 PYAR compared with 7.48 per 1000 PYAR for controls. The incidence of depression in the facial scarring group was 16.28 per 1000 PYAR compared with 9.56 per 1000 PYAR for controls. Age at the time of scarring, previous history of anxiety or depression, female gender, socioeconomic status and classification of scarring increased the risk of both anxiety disorders and depression. CONCLUSIONS There is a high burden of anxiety disorders and depression in this patient group. Risk of these mental health disorders is very much determined by factors apparent at the time of injury, supporting the need for psychological support.
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Affiliation(s)
- John A. G. Gibson
- Reconstructive Surgery & Regenerative Medicine Research Centre,
Institute of Life Science, Swansea University Medical School,
UK; and The Welsh Centre for Burns and Plastic Surgery,
Morriston Hospital, UK
| | - Thomas D. Dobbs
- Reconstructive Surgery & Regenerative Medicine Research Centre,
Institute of Life Science, Swansea University Medical School,
UK; and The Welsh Centre for Burns and Plastic Surgery,
Morriston Hospital, UK
| | - Rowena Griffiths
- Population Data Science, Swansea University Medical School, Faculty of
Medicine, Health & Life Science, Swansea University,
UK
| | - Jiao Song
- Population Data Science, Swansea University Medical School, Faculty of
Medicine, Health & Life Science, Swansea University,
UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of
Medicine, Health & Life Science, Swansea University,
UK; and Patient and Population Health and Informatics Research, Swansea
University Medical School, Faculty of Medicine, Health & Life Science,
Swansea University, UK
| | - Owen Bodger
- Patient and Population Health and Informatics Research, Swansea University
Medical School, Faculty of Medicine, Health & Life Science, Swansea
University, UK
| | - Hayley A. Hutchings
- Patient and Population Health and Informatics Research, Swansea University
Medical School, Faculty of Medicine, Health & Life Science, Swansea
University, UK
| | - Ronan A. Lyons
- Population Data Science, Swansea University Medical School, Faculty of
Medicine, Health & Life Science, Swansea University,
UK; and Patient and Population Health and Informatics Research, Swansea
University Medical School, Faculty of Medicine, Health & Life Science,
Swansea University, UK
| | - Ann John
- Population Data Science, Swansea University Medical School, Faculty of
Medicine, Health & Life Science, Swansea University,
UK; and Patient and Population Health and Informatics Research, Swansea
University Medical School, Faculty of Medicine, Health & Life Science,
Swansea University, UK
| | - Iain S. Whitaker
- Reconstructive Surgery & Regenerative Medicine Research Centre,
Institute of Life Science, Swansea University Medical School,
UK; and The Welsh Centre for Burns and Plastic Surgery,
Morriston Hospital, UK
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Hosseini SH, Mousavi Shalmaei SMA, Mohtasham-Amiri Z, Homaie Rad E, Khodadadi-Hassankiadeh N. Psychiatric symptoms and pain in maxillofacial injury following motor vehicle accidents: A comparative study. Dent Traumatol 2023; 39:31-37. [PMID: 36317713 DOI: 10.1111/edt.12793] [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: 06/06/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND/AIM Post-traumatic stress disorders, depression, and pain are rarely discussed in the literature on maxillofacial injuries, and psychiatric symptoms and pain are not identified and managed in such patients. The aim of this study was to determine the symptoms of post-traumatic stress disorders, depression, and pain in people with maxillofacial injuries following motor vehicle accidents. MATERIAL AND METHODS In this cross-sectional study, people injured in motor vehicle accidents from March to September 2015 who were referred to a medical educational center in the northern part of Iran for treatment follow-up were sampled. The existing symptoms of post-traumatic stress disorder by PSS, depression by BDI-II, and pain by NRS were assessed. SPSS software version 21 was used for analysis. RESULTS Maxillofacial injured patients had significant differences in terms of post-traumatic stress disorder (p = .006), depression (p = .001), pain (p = .001), and length of hospital stay (p = .002) than patients without maxillofacial injuries. CONCLUSIONS Motor vehicle accident victims with maxillofacial injuries suffered significantly more from post-traumatic stress disorders and depression, pain and length of hospital stay than patients with other injuries.
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Affiliation(s)
- Seyed Hadi Hosseini
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Zahra Mohtasham-Amiri
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Walshaw EG, Taylor R, Anderson J, Sexton P, Parmar JD, Carter LM. The psychological sequelae of maxillofacial trauma: a scoping review of the literature. Br J Oral Maxillofac Surg 2022; 60:1303-1320. [PMID: 36446645 DOI: 10.1016/j.bjoms.2022.09.013] [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: 06/21/2022] [Accepted: 09/05/2022] [Indexed: 11/27/2022]
Abstract
Managing the physical sequelae of facial trauma is routine for the maxillofacial surgeon. However, managing the psychological consequences is more challenging. The often violent mechanism of injury, changes in appearance, altered self-perception, and self-confidence can significantly impact daily life. This review summarises the literature regarding post-traumatic stress disorder (PTSD) and facial trauma, highlighting evidence to guide clinical practice. PubMed and MEDLINE were searched for relevant keywords and MeSH headings. Articles between 2000-2022 were independently reviewed by two authors. Articles were excluded if the full text was not available in English, did not relate to facial trauma, or was not related to PTSD/psychological sequelae. A total of 211 articles were retrieved. The most common reasons for exclusion were papers not reporting psychological outcomes (n = 68) or not relating to facial trauma (n = 35). Articles were sub-categorised to enable evaluation of key themes. Categories included children and adolescents, cross sectional, longitudinal studies, and interventional studies. Whilst there were potential confounders such as socioeconomic factors, overall, patients who had experienced facial trauma (regardless of the mechanism of injury) had an increased risk of PTSD and anxiety/depression. PTSD following facial injury is increasingly recognised as an important issue. A robust evidence base is desirable to inform clinical practice and provide holistic care to often vulnerable patients. Identifying those at increased risk of negative psychological sequelae is essential. We have appraised the literature relevant to OMFS trauma clinicians.
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Affiliation(s)
- Emma G Walshaw
- University of Leeds, Worsley Building, University of Leeds, Woodhouse, Leeds LS2 9JT, United Kingdom.
| | - Richard Taylor
- University of Leeds, Worsley Building, University of Leeds, Woodhouse, Leeds LS2 9JT, United Kingdom.
| | - Jane Anderson
- University of Huddersfield, Queensgate, Huddersfield HD1 3DH, United Kingdom.
| | - Paul Sexton
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
| | - Jiten D Parmar
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
| | - Lachlan M Carter
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
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Mishra P, Khan P, Salunkhe S, Pendyala S, Mathur M, Ummadisingh L, C. Tiwari R. Factors affecting quality of life in zygomatic fractures: An original research. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S242-S244. [PMID: 36110726 PMCID: PMC9469359 DOI: 10.4103/jpbs.jpbs_702_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/30/2021] [Accepted: 12/30/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Zygoma is one of the facial bones that are impacted in the accidents. Hence, we aim to evaluate the patient's profiles in the fracture associated with zygomatic bone. Materials and Methods: We conducted a prospective clinical study with 60 subjects who were divided equally into cases (30) and controls (30); controls were general population and the cases underwent surgery of zygomatic complex fracture. Health-related quality of life (HRQoL) was assessed by the means of the questionnaire. The values were compared for the significance keeping P < 0.05 as significant. Results: The preoperative 15D score was lesser for cases than controls. Soon after surgery, it was statistically least and after a month, the mean score surpassed the controls. Infraorbital sensory loss was seen even after 6 months. Conclusions: As expected, the HRQoL decreases only to improve after the surgery. However, the infra-orbital nerve sensory loss may continue for over 6 months after the zygomatic complex fracture.
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Dugue D, Taylor GA, Maroney J, Spaniol JR, Ramsey FV, Jones CM. Mind the Difference: Characterizing the Impact of Behavioral Health Disorders on Facial Trauma. J Surg Res 2021; 271:32-40. [PMID: 34837732 DOI: 10.1016/j.jss.2021.09.040] [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: 03/01/2021] [Revised: 09/09/2021] [Accepted: 09/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patients with psychiatric diagnoses are at greater risk for traumatic injury than the general population. Current literature fails to characterize how premorbid behavioral health disorders (BHDs) complicate craniofacial trauma. This study aimed to describe the characteristics and outcomes of patients with premorbid BHD sustaining facial fractures. METHODS All adults in the 2013-2016 Trauma Quality Improvement Program datasets with facial fractures were identified. Demographics, injury characteristics, fracture patterns, and in-hospital outcomes were compared in patients with and without premorbid BHDs. BHDs included major psychiatric illnesses, alcohol or drug use disorders, attention deficit hyperactivity disorder, or dementia. RESULTS Twenty-five percent of the 240,104 subjects with facial fractures had at least one premorbid BHD. Assault (29.9% versus 23.9%, P< 0.001), self-inflicted injury (2.9% versus 1.2%, P< 0.001), and multiple facial fractures (40.2% versus 38.7%, P< 0.001) were more common among the BHD group. The BHD group displayed significantly higher rates of nearly all in-hospital complications, including pneumonia (4.3% versus 3.3%, P< 0.001), substance withdrawal (3.9% versus 0.3%, P< 0.001), unplanned intubation (1.5% versus 0.9%, P< 0.001) and unplanned transfer to the intensive care unit (ICU, 1.3% versus 0.8%, P< 0.001). BHD was strongly predictive of pneumonia, unplanned intubation, and unplanned ICU admission in multivariate analyses. CONCLUSIONS Patients with BHD represent a subset of facial trauma characterized by different mechanisms and patterns of injury and premorbid health status. BHDs are associated with higher in-hospital complication rates and resource utilization. Understanding the relationship between craniofacial trauma and premorbid BHD creates opportunities to improve morbidity and resource utilization in this group.
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Affiliation(s)
- David Dugue
- Division of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - George A Taylor
- Division of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Jenna Maroney
- Division of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Joseph R Spaniol
- Division of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Frederick V Ramsey
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Christine M Jones
- Division of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania.
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Hoffman GR, Walton GM, Narelda P, Qiu MM, Alajami A. COVID-19 social-distancing measures altered the epidemiology of facial injury: a United Kingdom-Australia comparative study. Br J Oral Maxillofac Surg 2020; 59:454-459. [PMID: 33752920 PMCID: PMC7485452 DOI: 10.1016/j.bjoms.2020.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/04/2020] [Indexed: 11/03/2022]
Abstract
The purpose of this study was to undertake a retrospective cross-sectional analysis to compare the frequency and characteristics of facial injury presentations at a UK and an Australian tertiary referral hospital during the implementation of COVID-19 social-distancing measures. The primary predictor variables were a heterogeneous set of factors grouped into logical categories: demographics, injury mechanisms and site, and management. The primary outcome variable was the presentation of a hard or soft tissue facial injury. A descriptive statistical analysis was undertaken on the assembled data. The study found a clinical and statistically significant reduction in the frequency (absolute number) of facial injuries at each study site. In addition, a striking similarity common in both countries was an increase in the number of facial injuries due to falls and a reduction in facial injuries due to interpersonal violence. Conservative (non-operative) management of facial injury increased at both sites. The implementation of COVID-19 social-distancing public health measures, which aimed to limit community transmission of the coronavirus, had a secondary serendipitous effect of reducing the frequency of facial injury presentations and altering their epidemiological characteristics at both a UK and Australian tertiary referral hospital.
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Affiliation(s)
- G R Hoffman
- Maxillofacial and Head and Neck Surgery, John Hunter Hospital, Newcastle, Australia; School of Medicine, University of Newcastle, Australia.
| | - G M Walton
- Maxillofacial and Head and Neck Surgery, University Hospital Coventry and Warwickshire, NHS Trust, UK
| | - P Narelda
- Maxillofacial Surgery, University Hospitals Coventry and Warwickshire, NHS Trust, UK
| | - M M Qiu
- Maxillofacial Surgery, John Hunter Hospital, Newcastle, Australia
| | - A Alajami
- Maxillofacial Surgery, University Hospitals Coventry and Warwickshire, NHS Trust, UK
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7
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Shahrour G, Dardas LA. Acute stress disorder, coping self-efficacy and subsequent psychological distress among nurses amid COVID-19. J Nurs Manag 2020; 28:1686-1695. [PMID: 32767827 PMCID: PMC7436502 DOI: 10.1111/jonm.13124] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/19/2022]
Abstract
Purpose Health care professionals, particularly nurses, are considered a vulnerable group to experience acute stress disorder (ASD) and subsequent psychological distress amid COVID‐19 pandemic. This study aims to establish the prevalence of acute stress disorder and predictors of psychological distress among Jordanian nurses. Methods A quantitative, cross‐sectional, descriptive and comparative design was used. Data were collected using a Web‐based survey. A total of 448 Jordanian nurses (73% females) completed and returned the study questionnaire. Results The majority of nurses (64%) are experiencing ASD due to the COVID‐19 pandemic and thus are at risk for PTSD predisposition. More than one‐third of nurses (41%) are also suffering significant psychological distress. Among our sample, age, ASD and coping self‐efficacy significantly predicted psychological distress. More specifically, younger nurses are more prone to experience psychological distress than older ones. While higher scores on ASD showed more resultant psychological distress, coping self‐efficacy was a protective factor. Conclusion Given that individuals who suffer from ASD are predisposed to PTSD, follow‐up with nurses to screen for PTSD and referral to appropriate psychological services is pivotal. Coping self‐efficacy is found to ameliorate the effect of psychological distress on nurses' traumatic experience. Such findings warrant intensive efforts from health care institutions to provide psychosocial support services for nurses and ongoing efforts to screen them for traumatic and psychological distress symptoms. Implications for Nursing Management Nursing leaders and managers are in the forefront of responding to the unique needs of their workforces during the COVID‐19 crisis. They need to implement stress‐reduction strategies for nurses through providing consecutive rest days, rotating allocations of complex patients, arranging support services and being accessible to staff. They also need to ensure nurses' personal safety through securing and providing personal safety measures and undertake briefings to ensure their staff's physical and mental well‐being, as well as providing referrals to appropriate psychological services.
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Affiliation(s)
- Ghada Shahrour
- School of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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8
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Febbo A, Hoffman GR. To What Extent Does Illicit Drug Use Predispose to Facial Injury? An Institutional Investigation for an Emergent Problem. Craniomaxillofac Trauma Reconstr 2020; 14:11-15. [PMID: 33613830 DOI: 10.1177/1943387520928637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Study Design There are potential substantive linkages between illicit drug use and the occurrence of injury. Objective The purpose of our study was to determine the prevalence, class of illicit drugs abused, and demographics in relation to a cohort of patients who sustained facial injury. Methods The authors undertook a retrospective observational study of a prospectively accessioned cohort of patients who had sustained a facial injury and presented to the John Hunter Hospital (Newcastle, NSW, Australia). The primary predictor variable was the presentation of a facial injury and the secondary outcome variables included illicit drug use, alcohol use, and socioeconomic factors. The study was carried out over a 12-month period. A descriptive analysis was undertaken on the assembled data. Results Of the 465 patient medical records that were accessed for the study, 348 were male and 117 were female. Their average age was 42.6 years: 5.8% (n = 27) were under the influence of illicit drugs at the time of their presentation and 13.1% (n = 61) admitted to an intercurrent illicit drug habit. Those who were under the combined influence of alcohol and drugs comprised of 2.8% (n = 13). Conclusions Our study found that illicit drug use plays a small, but nonetheless, demonstrable role in the presentation of maxillofacial trauma patients to an urban level I trauma center. Illicit drug users are an emergent sociodemographic group of patients who can sustain facial trauma and their presentation needs to be appropriately considered, assessed, and managed collectively.
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Affiliation(s)
- Anthony Febbo
- Department of Maxillofacial Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, Newcastle, NSW, Australia
| | - Gary R Hoffman
- Department of Maxillofacial Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, Newcastle, NSW, Australia.,Medical School, University of Newcastle, Newcastle, NSW, Australia
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9
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Gopinath B, Jagnoor J, Kifley A, Pozzato I, Dinh M, Craig A, Cameron ID. Twelve-month health outcomes for bicyclists and car occupants after a non-catastrophic traffic crash injury. Ann Phys Rehabil Med 2020; 64:101368. [PMID: 32173544 DOI: 10.1016/j.rehab.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/05/2020] [Accepted: 02/21/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE In this inception cohort study, we investigated differences in health outcomes for bicyclists (cyclists) and car occupants (car driver and passengers) at 12months after a non-catastrophic traffic injury. We also aimed to determine the independent predictors of key health outcomes among cyclists. METHODS Of the 2019 participants at baseline, 299 were cyclists and 927 were car occupants; 229 cyclists and 489 car occupants were followed up 12months after the injury. A telephone-administered questionnaire was used to obtain information on socio-economic, pre-injury health and injury-related characteristics. The survey also included tools on health outcomes: quality of life (SF-36 and EQ-5D-3L scales), pain severity, general psychological distress, trauma-related distress and pain catastrophizing. RESULTS After adjusting for all potential confounders, general psychological distress scores and trauma-related distress scores were 2.05 and 0.60 units lower for cyclists than car occupants (P=0.01 and P<0.0001, respectively) at 12-month follow-up. Cyclists showed greater improvement than car occupants over 12months in mean pain severity ratings and SF-12 physical component summary (PCS) score (both P<0.0001) but had lower mean pain severity and similar PCS scores at baseline. However, cyclists showed less improvement in SF-12 mental component summary (MCS) scores (P=0.03) than car occupants but had higher mean MCS scores at baseline. Pre-injury and baseline quality-of-life scores and pain catastrophizing as well as injury involving the head or face were significant predictors of overall psychological functioning, general psychological distress and trauma-related distress in cyclists at 12months. CONCLUSIONS Cyclists demonstrated better recovery than car occupants at 12months after sustaining a traffic crash injury. Prognostic indicators of long-term physical functioning and psychological well-being in cyclists were related to pre-injury and baseline quality of life and pain factors and injury location.
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Affiliation(s)
- Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia.
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia; The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Annette Kifley
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ilaria Pozzato
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Michael Dinh
- Department of Trauma Services, Royal Prince Alfred Hospital, Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
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10
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Tan PG, Soh CL. Quality of life assessments in maxillofacial trauma patients – A systematic review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2020. [DOI: 10.1016/j.ajoms.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Analysis of Factors Affecting Quality of Life in Patients Treated for Maxillofacial Fractures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010004. [PMID: 31861285 PMCID: PMC6981460 DOI: 10.3390/ijerph17010004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022]
Abstract
Maxillofacial fractures (MFF) belong to the major modern medicine and public health concerns. The recovery from MFF is associated with a number of social problems. The patient’s mood may be affected by the change in self-image and lack of satisfaction with life, in many cases leading to a deepening of mental health disorders, resulting in alcoholism, loss of job or conflicts in the area of family life. The aim of this study was to evaluate the quality of life of patients with MFF, with respect to demographic and medical variables. The mean age of the 227 patients was 36 years. The mandible was the most frequent MFF location (52.9%), followed by the zygomatic bone (30.8%) then the maxilla (16.3%). Bone fracture displacement occurred in 79.3% of patients. A comminuted fracture was found in 71% of patients. The quality of life of patients with MFF was significantly better in all analyzed domains 3 months after the end of hospitalization compared to the initial survey carried out shortly after implementation of the treatment. Among the demographic variables, older age had a statistically significant but weak positive association with the improvement of the quality of life of respondents in General health perception domain.
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12
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Wilson N, Heke S, Holmes S, Dain V, Priebe S, Bridle C, Aylen I, Boyd C, Ramjaun G, Kanzaria A. Prevalence and predictive factors of psychological morbidity following facial injury: a prospective study of patients attending a maxillofacial outpatient clinic within a major UK city. DIALOGUES IN CLINICAL NEUROSCIENCE 2019. [PMID: 30936771 PMCID: PMC6436951 DOI: 10.31887/dcns.2018.20.4/sheke] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Adults presenting to maxillofacial surgery services are at high risk of psychological morbidity. This study examined the prevalence of depression, post-traumatic stress disorder (PTSD), anxiety, drug and alcohol use, and appearance-related distress among maxillofacial trauma outpatients over medium-term follow-up. It also explored socio-demographic and injury-related variables associated with psychological distress to inform targeted psychological screening protocols for maxillofacial trauma services. Significant associations were found between level of distress at time of injury and number of traumatic life events with levels of depression at 3 months. No significant associations were found between predictor variables and PTSD at 3 months, or with any psychiatric diagnosis at 6 months. The lack of evidence for an identifiable subgroup of patients who were at higher risk of psychological distress indicated that routine screening of all maxillofacial trauma outpatients should be offered in order to best respond to their mental health needs. The feasibility of the medical team facilitating this is challenging and should ideally be undertaken by psychologists integrated within the MDT. This study led to the funding of a clinical psychologist to provide collaborative care with the maxillofacial surgeons, resulting in brief assessment and treatment to over 600 patients in the first year of the service.
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Affiliation(s)
- Naomi Wilson
- Institute of Psychotrauma, East London NHS Foundation Trust, London, UK
| | - Sarah Heke
- Institute of Psychotrauma, East London NHS Foundation Trust, London, UK
| | - Simon Holmes
- Oral and Maxillofacial Surgery Department, the Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Victoria Dain
- Institute of Psychotrauma, East London NHS Foundation Trust, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, UK
| | - Christopher Bridle
- Oral and Maxillofacial Surgery Department, the Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Imogen Aylen
- Department of Psychology, University of East London, London, UK
| | - Caroline Boyd
- Department of Psychology, University of East London, London, UK
| | - Gonca Ramjaun
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, UK
| | - Amar Kanzaria
- Oral and Maxillofacial Surgery Department, the Royal London Hospital, Barts Health NHS Trust, London, UK
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13
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Gibson JAG, Ackling E, Bisson JI, Dobbs TD, Whitaker IS. The association of affective disorders and facial scarring: Systematic review and meta-analysis. J Affect Disord 2018; 239:1-10. [PMID: 29960147 DOI: 10.1016/j.jad.2018.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/29/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Facial scarring can have a dramatic effect on a patient's psychological health and wellbeing and present unique management challenges. This patient population remains poorly characterised in the contemporary literature. AIMS To evaluate the prevalence of, and risk factors associated with affective disorders in adult patients with facial scars. METHODS A systematic review was conducted using a protocol registered with PROSPERO and in line with the PRISMA statement. A comprehensive search of the literature was conducted using PubMed, MEDLINE, EMBASE, PSYCHInfo and The Cochrane Library. RESULTS Twenty one studies were included, with a total of 2,394 participants. Using a random effects model, the weighted pooled prevalence of anxiety was 26.1% (95% CI 17.9%-36.3%) and the weighted pooled prevalence of depression was 21.4% (95% CI 15.4%-29.0%). Studies identified female gender, past psychiatric history and violent causation as factors associated with anxiety and depression. LIMITATIONS Included studies were limited to those published in peer reviewed journals. Longitudinal trends in both anxiety and depression were limited by a short duration of follow up. CONCLUSIONS There is a high and persistent burden of affective disorders in patients with facial scars. Additional research is required to further characterise this population and develop effective management strategies.
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Affiliation(s)
- John A G Gibson
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL.
| | - Edward Ackling
- School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK, CF14 4NX
| | - Thomas D Dobbs
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL; School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN
| | - Iain S Whitaker
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL; School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN
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14
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Kaukola L, Snäll J, Roine R, Sintonen H, Thorén H. Health-related quality of life of patients with zygomatic fracture. Med Oral Patol Oral Cir Bucal 2017; 22:e636-e642. [PMID: 28809377 PMCID: PMC5694188 DOI: 10.4317/medoral.21914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/13/2017] [Indexed: 11/23/2022] Open
Abstract
Background The objective was to evaluate health-related quality of life (HRQoL) before and after surgical treatment of zygomatic complex fracture and assess patients’ perceptions of the aesthetic and functional outcomes of surgery. Material and Methods A prospective study of 79 adult patients before and after surgery for zygomatic complex fracture was conducted. HRQoL was measured using the generic 15-dimensional (15D) instrument, and patient satisfaction was assessed by an additional questionnaire. Results The mean preoperative 15D score for patients was lower than for general population that was matched for age and gender (p=0.011). The mean 15D score was lowest on the first postoperative day (p<0.001) when patients were worse off for 6 of the 15 dimensions of the HRQoL instrument and better off for three dimensions. However, patients achieved, and even exceeded, the mean 15D score of the general population during the first month following surgery. Infraorbital sensory loss at the end of the six-month follow-up appeared to be the single most important factor that plagued the patients. Conclusions HRQoL is significantly reduced after trauma but improves a few weeks after surgery. Infraorbital nerve sensory loss is a notable long-term factor that affects patients after zygomatic complex fracture. Key words:Zygomatic fracture, maxillofacial trauma, health-related quality of life, disturbance of infraorbital nerve, facial sensation.
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Affiliation(s)
- L Kaukola
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, FI-00029 HUH, Finland,
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Choudhury-Peters D, Dain V. Developing psychological services following facial trauma. BMJ QUALITY IMPROVEMENT REPORTS 2016; 5:bmjquality_uu210402.w4210. [PMID: 27493750 PMCID: PMC4964208 DOI: 10.1136/bmjquality.u210402.w4210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/29/2016] [Indexed: 11/04/2022]
Abstract
Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress.
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Gandjalikhan-Nassab SAH, Samieirad S, Vakil-Zadeh M, Habib-Aghahi R, Alsadat-Hashemipour M. Depression and anxiety disorders in a sample of facial trauma: A study from Iran. Med Oral Patol Oral Cir Bucal 2016; 21:e477-82. [PMID: 26946207 PMCID: PMC4920462 DOI: 10.4317/medoral.21068] [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: 09/24/2015] [Accepted: 11/24/2015] [Indexed: 11/15/2022] Open
Abstract
Background Various studies have shown that such patients are susceptible to psychological problems and poor quality of life. The aim of the present study was to evaluate and compare the prevalence of depression and anxiety disorders and quality of life in a group of facial trauma. Material and Methods In the present cross-sectional study Hospital Anxiety and Depression Scale (HADS) and Oral Health Impact (OHIP-14) questionnaires were used. In this study, fifty subjects were selected from the patients with maxillofacial traumas based on the judgment of the physicians, referring to hospitals in Kerman and Rafsanjan during 2012-2013. In addition, 50 patients referring to the Dental School for tooth extraction, with no maxillofacial traumas, were included. SPSS 13.5 was used for statistical analysis with two-sample t-test, Mantel-Haenszel technique, Pearson’s correlation coefficient and chi-squared test. Results Seven patients with maxillofacial traumas were depressed based on HADS depression scale, with 5 other borderline cases. However, patients referring for surgery or tooth extraction only 2 were depressed and 1 patient was a borderline case. The results showed that patients with maxillofacial traumas had higher rates of depression and anxiety, with significant differences between this group and the other group (P=0.01). The results of the present study showed a significant prelateship between depression severity and confounding factors. The mean of OHIP-14 parameters were 35.51 ±5.2 and 22.3±2.4 in facial trauma and dental surgery groups, respectively, with statistically significant differences (P=0.01). Conclusions The results of the present study showed depression and anxiety disorders in patients with maxillofacial trauma. The results showed a higher rate of anxiety and anxiety in patients with maxillofacial traumas compared to the control group. Key words:Depression, facial trauma, HADS, OHIP-14, questionnaire.
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Affiliation(s)
- S-A-H Gandjalikhan-Nassab
- Department of Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran,
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Hassan HA, Suriya MO, Al-Aseri ZA, Hasan M, Khalid N, Sheikh SA. Feasibility of using Arabic Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression among patients attending Accident and Emergency at a University Hospital setting in Riyadh, Saudi Arabia. Pak J Med Sci 2015; 31:1366-71. [PMID: 26870098 PMCID: PMC4744283 DOI: 10.12669/pjms.316.6849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/01/2014] [Accepted: 09/06/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility of using Arabic Hospital Anxiety and Depression Scale (HADS) to assess depression and anxiety among patients attending accident and emergency (A & E) at a University Hospital setting in Riyadh, Saudi Arabia. METHODS In this prospective observational study translated questionnaire of HADS was used for patients aged 18 years or above who presented to A & E at King Khalid University Hospital in Riyadh, Saudi Arabia. The study included 257 patients as per an agreed inclusion criteria. The study quantified depression and anxiety and its association with demographic and or illness related variables using SPSS. RESULTS Out of 257 participants, the dominant age group, ranged between 18-30 years (40.9%) with female participants (55.3%) outweigh the male among all. The overall occurrence of depression was 27.2% (95% Confidence Interval (CI): 21.8 % to 32.6%) and anxiety was 23% (17.8% to 28.2%CI). Marital, educational and economic status of participants, were statistically significantly associated (p<0.05) with the levels of anxiety whereas age, marital, education, economic and employment status were associated (p<0.05) with the levels of depression. CONCLUSION In the A & E setting at University Hospital in Saudi Arabia, comorbid depression and anxiety is not uncommon as enumerated by using HADS. The identified cases could then be sent for appropriate psychiatric treatment promptly not only to improve quality of individual care but also to reduce the overall health care costs in local context.
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Affiliation(s)
- Hosam A. Hassan
- Hosam A. Hassan, MBBCh, MRCPI. Assistant Professor and Consultant, Department of Emergency Medicine (65), College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - M. Owais Suriya
- M. Owais Suriya, MBBS, DTCD, MRCP (UK), MRCGP (UK) FCEM (UK). Research Fellow College of Medicine, University of Saskatchewan. 107, Wiggins Road S7N 5E5, Saskatoon, Canada
| | - Zohair Ahmed Al-Aseri
- Zohair Ahmed Al-Aseri, FRCPc, EM & CC. Associate Professor, Department of Emergency Medicine (65), College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Mujtaba Hasan
- Mujtaba Hasan, MBBS, BSc, FCPS, FCCP, DTP Assistant Professor of Medicine, Consultant Physician, University College of Medicine, University of Lahore, Pakistan
| | - Najeeb Khalid
- Najeeb Khalid, MBBS (PK), MD (UK). Consultant Psychiatrist & HonSr Lecturer, Cardiff & Vale University Health Board, Cardiff, United Kingdom
| | - Shaffi Ahmed Sheikh
- Shaffi Ahmed Sheikh, Ph.D. Associate Professor, Dept. Of Family & Community Medicine, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
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Razavi SM, Tahani B, Nouri S, Khazaei A. Oral Cancer Knowledge and Practice among Dental Patients and their Attitude Towards Tobacco Cessation in Iran. Asian Pac J Cancer Prev 2015. [PMID: 26225691 DOI: 10.7314/apjcp.2015.16.13.5439] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One of the main causes of delay in diagnosis of oral cancer is lack of awareness about aetiology and symptoms among the general population. The aim of this study was to assess the knowledge and practice of patients regarding oral cancer and their attitude towards tobacco cessation. MATERIALS AND METHODS This study was carried out in Isfahan-Iran in 2014. A 29-item self-administrated questionnaire was designed and piloted and distributed to patients attending dental clinics. Questions were focused on awareness about oral cancer risk factors, signs and symptoms, places in the mouth which are more susceptible and attitude toward tobacco cessation. Chi-square, T-test, ANOVA and logistic regression tests were used for statistical analysis. RESULTS A total of 546 valid completed questionnaires were obtained. The mean knowledge score of patients was 4.1(±2.7) out of 13. Some 80% of patients did not know about early manifestations of oral cancer. Only 18% knew the most likely sites of oral cancer. Only 43.1% and 65.2% of patients reported alcohol and tobacco consumption as the main risk factors but they had a fair knowledge about other risk factors. There was no significant difference in Knowledge level between patients regarding their sex, educational levels and age. Most patents (90%) expected their dentists to warn them about the harmful effects of smoking and showed willingness to quit if recommended. CONCLUSIONS Knowledge about oral cancer was found to be quite low. It seems necessary to increase the level of public awareness using educational programs with cooperation of dentists in tobacco cessation programs.
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Affiliation(s)
- Sayed Mohammad Razavi
- Dental Implant Research Center, Department of Oral Pathology, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran E-mail :
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Kaukola L, Snäll J, Lindqvist C, Roine R, Sintonen H, Törnwall J, Thorén H. Health-related quality of life after surgical treatment of mandibular fracture. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:402-7. [DOI: 10.1016/j.oooo.2014.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 11/17/2014] [Indexed: 11/16/2022]
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Trends in Facial Fracture Treatment Using the American College of Surgeons National Surgical Quality Improvement Program Database. Plast Reconstr Surg 2014; 133:627-638. [DOI: 10.1097/01.prs.0000438457.83345.e9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kommers SC, van den Bergh B, Forouzanfar T. Quality of life after open versus closed treatment for mandibular condyle fractures: A review of literature. J Craniomaxillofac Surg 2013; 41:e221-5. [DOI: 10.1016/j.jcms.2013.01.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/19/2012] [Accepted: 01/09/2013] [Indexed: 10/27/2022] Open
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Abdeshahi SK, Hashemipour MA, Mesgarzadeh V, Shahidi Payam A, Halaj Monfared A. Effect of hypnosis on induction of local anaesthesia, pain perception, control of haemorrhage and anxiety during extraction of third molars: A case–control study. J Craniomaxillofac Surg 2013; 41:310-5. [DOI: 10.1016/j.jcms.2012.10.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 10/17/2012] [Accepted: 10/18/2012] [Indexed: 11/16/2022] Open
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Kraft A, Abermann E, Stigler R, Zsifkovits C, Pedross F, Kloss F, Gassner R. Craniomaxillofacial trauma: synopsis of 14,654 cases with 35,129 injuries in 15 years. Craniomaxillofac Trauma Reconstr 2013; 5:41-50. [PMID: 23449961 DOI: 10.1055/s-0031-1293520] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 06/16/2011] [Indexed: 10/15/2022] Open
Abstract
Craniomaxillofacial (CMF) trauma occurs in isolation or in combination with other serious injuries, including intracranial, spinal, and upper- and lower-body injuries. It is a major cause of expensive treatment and rehabilitation requirements, temporary or lifelong morbidity, and loss of human productivity. The aim of this study was to evaluate patterns of CMF trauma in a large patient sample within a 15-year time frame. Between 1991 and 2005, CMF trauma data were collected from 14,654 patients with 35,129 injuries at the Department of Cranio-Maxillofacial and Oral Surgery in Innsbruck, assessing a plethora of parameters such as injury type and mechanism as well as age and gender distribution over time. Three main groups of CMF trauma were evaluated: facial bone fractures, dentoalveolar trauma, and soft tissue injuries. Statistical comparisons were carried out using a chi-square test. This was followed by a logistic regression analysis to determine the impact of the five main causes for CMF injury. Older people were more prone to soft tissue lesions with a rising risk of 2.1% per year older, showing no significant difference between male and female patients. Younger patients were at higher risk of suffering from dentoalveolar trauma with an increase of 4.4% per year younger. This number was even higher (by 19.6%) for female patients. The risk of sustaining facial bone fractures increased each year by 4.6%. Male patients had a 66.4% times higher risk of suffering from this type of injury. In addition, 2550 patients (17.4%) suffered from 3834 concomitant injuries of other body parts. In summary, we observed changing patterns of CMF trauma over the last 15 years, paralleled by advances in refined treatment and management options for rehabilitation and reconstruction of patients suffering from CMF trauma.
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Affiliation(s)
- Anna Kraft
- Department of Cranio-Maxillofacial and Oral Surgery
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Islam S, Cole JL, Walton GM, Dinan TG, Hoffman GR. Psychiatric outcomes in operatively compared with non-operatively managed patients with facial trauma: Is there a difference? J Plast Surg Hand Surg 2012; 46:399-403. [DOI: 10.3109/2000656x.2012.718715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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