Traumatismos maxilo-faciais por acidentes de trânsito e queda e fatores associados: um estudo retrospectivo

Abstract

Maxillofacial injuries (MFI) are health-impacting problems worldwide with physical, economic and social repercussions and result in many cases of urgency care and morbidity in trauma centers and in the lack hospital beds, as well as expenses for the treatment, recovery and rehabilitation of patients. This research aimed to determine the pattern of MFI for traffic accidents and falls at a hospital of reference in northeastern Brazil, between December 2011 and December 2018 and to identify associated factors. This was a cross-sectional study and analyzed 585 medical records of patients with MFI. Data were included in Poisson multiple regression analysis and Tweedie multivariate regression to estimate the prevalence ratio (PR), with a 95% confidence interval (95%CI) and significance p<0.05. The MFI originated mainly from traffic accidents (52.6%) and falls (29.6%). The occurrence of MFI due to traffic accidents was more prevalent in patients aged from 21 to 40 years old (PR=2.30; 95%CI=1.20-4.41; p<0.001), diagnosed with fracture of the orbital zygomatic complex (PR=1.80;95%CI=1.08-2.98; p=0.023). Older age groups were more involved in falls: 41 to 60 years old (PR=1.83; 95%CI=1.09-3.06; p=0.022); over 61 years old (PR=2.23; 95%CI=1.09-3.06; p=0.022). In traffic accidents, alcohol consumption influenced the length of hospital stay (PR=2.081; 95% CI=1.553-2.787; p<0.001) and patients who did not use personal protective equipment (PPE) had higher hospital costs (PR=179.964; 95%CI=1.485-1.994; p<0.001 and patients who did not use personal protective equipment (PPE) had higher hospital costs (PR=179.964; 95%CI=1.485-1.994; p<0.001) in this etiology. It was concluded that traffic accidents and falls are two of the main etiologies of MFI, especially in males among young adults for traffic accidents, and over 41 years old for falls. In general, alcohol consumption and nonuse of PPE influenced length of hospital stay and costs. Strategies can be adopted to understand the factors associated with MFI, as well as to improve the quality of health care of users, such as decentralization of services, redirection in hospital costs, and improvement of road and highway surveillance, as well as implementation of prevention programs.