Comparative study of four trauma scoring systems to evaluate maxillofacial fractures

doi:10.19438/j.cjoms.2021.04.012

Abstract

Abstract: PURPOSE: To select a scoring system suitable for scoring of maxillofacial trauma by comparing the effects of four commonly used trauma scoring systems. METHODS: This study cohort comprised 1 009 patients with maxillofacial trauma from January 2008 to December 2013 at Peking University School and Hospital of Stomatology. There were 46 cases with simple maxillary fractures, 536 cases with simple mandibular fractures, 233 cases with simple zygomatic arch fractures, and 194 cases with compound fractures. New Injury Severity score (NISS), Facial Injury Severity Score (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS) were used to grade the injury severity of the patients before surgery. The data were imported into SPSS 21.0 software package. Correlation coefficients between the results of the four scoring systems and clinical effective indexes were calculated by non-parametric correlation analysis. Multivariate linear regression analysis was carried out with length of stay and hospitalization expenses as dependent variables. RESULTS: There was no significant difference between the score of mandibular fracture and zygomatic fracture by NISS. When FISS, MFISS, and MISS were applied, there was no significant difference between maxillary fracture scores and mandibular fracture scores(P>0.05). NISS, FISS, MFISS and MISS were positively correlated with operation time, cost of anesthesia, length of hospitalization stay, and correlation coefficients of MFISS were the highest(0.475,0.485, 0.434). The difference was statistically significant(P<0.05). Trauma score and concomitant injury were positively significant influencing factors of length of hospital stay and hospitalization expenses(P<0.05). CONCLUSIONS: MFISS showed the highest correlation with clinical effective indexes, and affected the length of hospital stay and hospitalization expenses significantly. MFISS reflected the injury severity of maxillofacial trauma better.

Key words: Maxillofacial trauma, Facial fracture, Trauma scoring, Injury severity score

CLC Number:

R782.4

CHEN Chen, SUN Ning-ning, HE Yang, AN Jin-gang, GONG Xi, ZHANG Yi. Comparative study of four trauma scoring systems to evaluate maxillofacial fractures[J]. China Journal of Oral and Maxillofacial Surgery, 2021, 19(4): 350-353.

References

[1] Ahmad Z, Nouraei R, Holmes S.Towards a classification system for complex craniofacial fractures[J]. Br J Oral Maxillofac Surg, 2012, 50(6): 490-494.
[2] 张益. 我国口腔颌面创伤外科发展的思考和建议[J].中华口腔医学杂志,2008,43(11):641-645.
[3] Chen C, Zhang Y, An JG, et al.Comparative study of four maxillofacial trauma scoring systems and expert score[J]. J Oral Maxillofac Surg, 2014, 72(11): 2212-2220.
[4] Osler T, Baker SP, Long W.A modification of the injury severity score that both improves accuracy and simplifies scoring[J]. J Trauma, 1997, 43(6): 922-926.
[5] Bagheri SC, Dierks EJ, Kademani D, et al.Application of a facial injury severity scale in craniomaxillofacial trauma[J]. J Oral Maxillofac Surg, 2006, 64(3): 408-414.
[6] Zhang J, Zhang Y, El-Maaytah M, et al.Maxillofacial Injury Severity Score: proposal of a new scoring system[J]. Int J Oral Maxillofac Surg, 2006, 35(2): 109-114.
[7] 李戍军,刘彦普,石照辉,等.3种创伤严重度评分对颌面创伤评估的比较[J].解放军医学杂志,2004, 29(1): 66-68.
[8] 李祖兵,张益,刘彦普.口腔颌面创伤外科学[M].北京:人民卫生出版社,2011:68-70.
[9] Cannell H, Paterson A, Loukota R.Maxillofacial injuries in multiply injured patients[J]. Br J Oral Maxillofac Surg, 1996, 34(4): 303-308.
[10] 薄斌,顾晓明,周树夏.颌面部创伤严重度评价的改进[J].实用口腔医学杂志, 2000, 16(3): 178-180.
[11] 葛成,何黎升,顾晓明,等.改良面部损伤严重度评分法评价颌面部创伤1134例[J].中华创伤杂志, 2001, 17(5): 275-276.
[12] 薄斌,周树夏,顾晓明.AIS-ISS创伤评分法及其在颌面创伤中的应用[J].中华口腔医学杂志,2001, 36(2): 155-157.
[13] Cooter RD, David DJ.Computer-based coding of fractures in the craniofacial region[J]. Br J Plast Surg, 1989, 42(1): 17-26.
[14] Catapano J, Fialkov JA, Binhammer PA, et al.A new system for severity scoring of facial fractures: development and validation[J]. J Craniofac Surg, 2010, 21(4): 1098-1013.
[15] Yamamoto K, Matsusue Y, Horita S, et al.Clinical analysis of midfacial fractures[J]. Mater Sociomed, 2014, 26(1): 21-25.
[16] Sahni V.Maxillofacial trauma scoring systems[J]. Injury, 2016, 47(7): 1388-1392.
[17] Waterkamp V, Ricklin M, Schaller B, et al.Severity and pattern of injuries caused by the traditional Swiss team sport 'Hornussen': first retrospective study at a level I trauma centre in Switzerland[J]. BMJ Open Sport Exerc Med, 2016, 2(1): e000122.
[18] Furr AM, Schweinfurth JM, May WL.Factors associated with long-term complications after repair of mandibular fractures[J]. Laryngoscope, 2006, 116(3): 427-430.
[19] Bocchialini G, Castellani A.Facial trauma: a retrospective study of 1 262 patients[J]. Ann Maxillofac Surg, 2019, 9(1): 135-139.
[20] Ramalingam S.Role of maxillofacial trauma scoring systems in determining the economic burden to maxillofacial trauma patients in India[J]. J Int Oral Health, 2015, 7(4): 38-43.
[21] O'Meara C, Witherspoon R, Hapangama N, et al. Alcohol and interpersonal violence may increase the severity of facial fracture[J]. Br J Oral Maxillofac Surg, 2012, 50(1): 36-40.
[22] Bertram A, Hyam D, Hapangama N.Out-of-hours maxillofacial trauma surgery: a risk factor for complications?[J]. Int J Oral Maxillofac Surg, 2013, 42(2): 214-217.
[23] Velayutham L, Sivanandarajasingam A, O'Meara C, et al. Elderly patients with maxillofacial trauma: the effect of an ageing population on a maxillofacial unit's workload[J]. Br J Oral Maxillofac Surg, 2013, 51(2): 128-132.
[24] Aladelusi T, Akinmoladun V, Olusanya A, et al.Analysis of road traffic crashes-related maxillofacial injuries severity and concomitant injuries in 201 patients seen at the UCH, Ibadan[J]. Craniomaxillofac Trauma Reconstr, 2014, 7(4): 284-289.
[25] Shetty V, Atchison K, Der-Matirosian C, et al.The mandible injury severity score: development and validity[J]. J Oral Maxillofac Surg, 2007, 65(4): 663-670.
[26] 陈晨,张益,安金刚,等.3种颌面部创伤评分评估下颌骨骨折的比较研究[J].实用口腔医学杂志,2015,31(1): 68-72.