(41) In Patients Who Sustain a Gunshot Wound to The Face, Does The Region of the Face Involved Affect The Likelihood of Receiving Surgery? A 10 year Review From a Single Civilian Level I Trauma Center

Thursday, September 15, 2022

1:30 PM – 3:00 PM CDT

Independent Variable

Surgical Intervention by Facial Region

Race of Cohort

Presenting Author(s)

Preston Banoub, DMD

OMFS Resident
Cook County
Chicago, Illinois, United States

Co-Author(s)

MQ

Mohammed Qaisi, MD DDS

chairman
AAOMS
chicago, Illinois, United States
BS

Biraj Shah, MD FACS DDS

attending
AAOMS
chicago, Illinois, United States
ME

Max Emmerling, DDS, MD

Attending
Cook County
Chicago, Illinois, United States
SM

Stephen Martin, DDS

OMFS
Cook County
Chicago, Illinois, United States
FB

Faran Bokhari, MD

Chairman, Cook County Trauma & Burn Unit
Cook County
Chicago, Illinois, United States
JM

James Murphy, MD DDS FACS

Chief investigator
John Stroger
chicago, Illinois, United States

Disclosure(s):

Preston Banoub, DMD: No financial relationships to disclose

mohammed Qaisi, MD DDS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

biraj Shah, MD FACS DDS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Max Emmerling, DDS, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Stephen Martin, DDS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Faran Bokhari, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

James Murphy, MD DDS FACS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Abstract: Abstract

Introduction: Maxillofacial Gunshot wounds (GSW) are complex injuries associated with life-threatening complications along with devastating functional and aesthetic consequences. The purpose of this study was to determine whether the need for surgical intervention can be anticipated based on the affected region of the face, specifically the upper face (UF) middle face (MF) and lower face (LF).

Methods:
A sample size calculation was performed to be in order to determine the number of patients needed in each arm to detect a detect a 25% effect size between the three facial regions with alpha=0.05 and power of 0.8. This was calculated using a 1-way ANOVA pairwise comparison for proportions model.

Review of the trauma data registry at Cook County Health between January 2008 and July 2018 revealed a total 180 GSW injuries involving the maxillofacial region, with 120 of these excluding other multi-organ injuries. This was deemed to an adequate sample size to answer the research question based on the power calculation.

A retrospective chart review of all patients treated during the above mentioned time frame
was performed. Facial regions were retrospectively categorized based on review CT scan
imaging and reports. Data collection included patient demographics, age, sex, race, the type of surgical intervention required, vascular injury, the need for angiography, blood transfusion, embolization, neck exploration, hospital and ICU length of stay.

Results: The median age in this cohort was 25 years, with 80.6% of victims being African American and 94% being males. The number of injuries per facial region were as follows: LF=39, MF=27, and UF=20. Injuries involving combinations of the above made up 34 cases.

The involved facial region appeared to have an effect on the need for surgery (Chi-square 22.703, p< 0.000). Injuries of the LF were 4.5 times more likely to require surgery than the UF injuries (UF - LF Odds ratio 0.221, 95% CI 0.0603 – 0.806), and 16 times more than injuries of the MF (MF -LF Odds ratio 0.0619 , 95% CI 0.0177 – 0.2162).

Conclusion: GSW injuries to the LF are more likely to require surgical intervention than other regions of the face.