Estimated prevalence of facial injury-related mortality in the United States pediatric population

Background/Aims: In pediatric populations, the epidemiology of facial trauma, their injury patterns, distribution, and outcomes are well known, However, little is known about the risk factors and impacts of minor and moderate facial injuries on in-hospital mortality among children in the United States of America (USA). The aim of this study was to determine the prevalence and risk factors for in-hospital mortality among pediatric patients following facial injuries in the USA. Material and Methods: A cross-sectional study was conducted with data from the National Trauma Data Bank's pediatric hospitalized patients (<18 years) with facial injuries (International Classification of Diseases, Ninth Revision codes 802.00 to 802.9 and Tenth Revision codes S02.2 to S02.92) between January 01, 2016–December 31, 2019. A multivariable logistic regression model was utilized to identify the risk factors for in-hospital mortality. Results: A total of 61,294 pediatric patients (mean age 11.9 years, 69.6% males) were included in the analysis. The estimated prevalence of in-hospital mortality following facial injuries was 2.4% (n = 1480). In terms of mortality, compared to those who sustained minor facial injuries, patients with (1) moderate injuries had 43% higher odds (OR = 1.43; 95% CI: 1.25–1.64, p <.0001), (2) serious injuries had seven times higher odds (OR = 7.81; 95% CI: 6.67–9.14, p <.0001), (3) severe injuries had 16 times higher odds (OR = 16.07; 95% CI: 12.62–20.46, p <.0001), and (4) critical/maximum injury virtually unsurvivable had 145 times higher odds (OR = 145.24; 95% CI: 113.82–185.33, p <.0001) of death after controlling for age, race, insurance status, comorbidities, and hospital complications. Conclusions: The severity of facial injury, age 5–17 years, uninsured status, and those with a mental/personality disorder were risk factors for in-hospital mortality among pediatric patients following facial injuries in this population-level analysis. A better understanding of these risk factors is needed for clinical management of pediatric patients to prevent in-hospital mortality following facial injuries.