Correlating the Bony Facial Trauma Score with Clinical Outcomes

The Comprehensive Facial Injury (CFI) Score Is an Early Predictor of the Management for Mild, Moderate and Severe Facial Trauma

Identifying groups of patients with homogeneous characteristics and comparable outcomes improves clinical activity, patients' management, and scientific research. This study aims to define mild, moderate, and severe facial trauma by validating two cut-off values of the Comprehensive Facial Injury (CFI) score and describing their foreseeable clinical needs to create a useful guide in patient management, starting from the first evaluation. The individual CFI score, overall surgical time, and length of hospitalization are calculated for a sample of 1400 facial-injured patients. Receiver Operating Characteristic (ROC) analysis and the corresponding Area Under the Curve (AUC) is tested, and a CFI score ≥4 is selected to discriminate patients undergoing surgical management under general anesthesia (Positive Predictive Value, PPV of 91.4%), while a CFI score ≥10 is selected to identify patients undergoing major surgical procedures (Negative Predictive Value, NPV of 91.7%). These results are enhanced by the consensual trend of Length of Stay outcome. The use of the CFI score allows us to distinguish between the "Mild facial trauma" with a low risk of hospitalization for surgical treatment, the "Moderate facial trauma" with a high probability of surgical treatment, and the "Severe facial trauma" that requires long-lasting surgery and hospital stay, with an increased incidence of Intensive Care Unit admission.