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A Cross-sectional Study of the Association between Homelessness and Facial Fractures

BACKGROUND: Little is known about the risk factors for facial fractures among homeless patients. We investigated the association between homelessness, mechanism of injury, and type of facial fracture in patients treated at an urban trauma center. METHODS: Data for 2,221 adults with facial fractures...

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Autores principales: Nguyen, Audrey B., Grimes, Barbara, Neuhaus, John, Pomerantz, Jason H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635210/
https://www.ncbi.nlm.nih.gov/pubmed/31624672
http://dx.doi.org/10.1097/GOX.0000000000002254
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author Nguyen, Audrey B.
Grimes, Barbara
Neuhaus, John
Pomerantz, Jason H.
author_facet Nguyen, Audrey B.
Grimes, Barbara
Neuhaus, John
Pomerantz, Jason H.
author_sort Nguyen, Audrey B.
collection PubMed
description BACKGROUND: Little is known about the risk factors for facial fractures among homeless patients. We investigated the association between homelessness, mechanism of injury, and type of facial fracture in patients treated at an urban trauma center. METHODS: Data for 2,221 adults with facial fractures were obtained retrospectively from a standardized registry of trauma patients at Zuckerberg San Francisco General Hospital from 2011 to 2016. Associations between homelessness and mechanism of injury, facial fracture type, and surgical repair type were evaluated with multivariate multinomial logistic regression analysis. RESULTS: Among 2,221 patients with facial fractures, 12% were homeless and, compared with housed patients, more likely to be male, black, and test positive for drug and alcohol use (all P < 0.0001). They had lower injury severity scores but longer hospital stays and were more likely to be discharged to the community than to a rehabilitation facility (all P < 0.0001). After adjusting for confounding variables, homeless patients with facial fractures were nearly 3-fold more likely to have been assaulted than housed patients (OR = 2.8, 95% CI = 1.9–4.1, P < 0.0001) and twice as likely to have mandible fractures (OR = 2.0, 95% CI = 1.3–3.0, P = 0.0030) and to have surgery for these fractures (OR = 2.1, 95% CI = 1.2–3.7, P = 0.0110). CONCLUSIONS: Our novel results demonstrate that homeless patients with facial fractures are at much higher risk than the general population for being assaulted, suffering mandible fractures, and requiring surgery for these fractures. Further investigations could guide identification, treatment, and prevention efforts.
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spelling pubmed-66352102019-10-17 A Cross-sectional Study of the Association between Homelessness and Facial Fractures Nguyen, Audrey B. Grimes, Barbara Neuhaus, John Pomerantz, Jason H. Plast Reconstr Surg Glob Open Original Article BACKGROUND: Little is known about the risk factors for facial fractures among homeless patients. We investigated the association between homelessness, mechanism of injury, and type of facial fracture in patients treated at an urban trauma center. METHODS: Data for 2,221 adults with facial fractures were obtained retrospectively from a standardized registry of trauma patients at Zuckerberg San Francisco General Hospital from 2011 to 2016. Associations between homelessness and mechanism of injury, facial fracture type, and surgical repair type were evaluated with multivariate multinomial logistic regression analysis. RESULTS: Among 2,221 patients with facial fractures, 12% were homeless and, compared with housed patients, more likely to be male, black, and test positive for drug and alcohol use (all P < 0.0001). They had lower injury severity scores but longer hospital stays and were more likely to be discharged to the community than to a rehabilitation facility (all P < 0.0001). After adjusting for confounding variables, homeless patients with facial fractures were nearly 3-fold more likely to have been assaulted than housed patients (OR = 2.8, 95% CI = 1.9–4.1, P < 0.0001) and twice as likely to have mandible fractures (OR = 2.0, 95% CI = 1.3–3.0, P = 0.0030) and to have surgery for these fractures (OR = 2.1, 95% CI = 1.2–3.7, P = 0.0110). CONCLUSIONS: Our novel results demonstrate that homeless patients with facial fractures are at much higher risk than the general population for being assaulted, suffering mandible fractures, and requiring surgery for these fractures. Further investigations could guide identification, treatment, and prevention efforts. Wolters Kluwer Health 2019-06-27 /pmc/articles/PMC6635210/ /pubmed/31624672 http://dx.doi.org/10.1097/GOX.0000000000002254 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Nguyen, Audrey B.
Grimes, Barbara
Neuhaus, John
Pomerantz, Jason H.
A Cross-sectional Study of the Association between Homelessness and Facial Fractures
title A Cross-sectional Study of the Association between Homelessness and Facial Fractures
title_full A Cross-sectional Study of the Association between Homelessness and Facial Fractures
title_fullStr A Cross-sectional Study of the Association between Homelessness and Facial Fractures
title_full_unstemmed A Cross-sectional Study of the Association between Homelessness and Facial Fractures
title_short A Cross-sectional Study of the Association between Homelessness and Facial Fractures
title_sort cross-sectional study of the association between homelessness and facial fractures
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635210/
https://www.ncbi.nlm.nih.gov/pubmed/31624672
http://dx.doi.org/10.1097/GOX.0000000000002254
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