Identifying risk factors of cerebrovascular injuries following blunt mandible fracture; a retrospective study from a national data base.

Abstract

The purpose of this study was to determine the risk factors of cerebrovascular injury (CVI) in patients with blunt mandible fractures. All patients who sustained a mandible fracture as a result of blunt force trauma from the 2012-2014 National Trauma Data Bank from the United State of America were included in the study. A CVI was noted as having occurred if there was an injury to the vertebral or carotid artery in the neck. Patients' demography, injury mechanism, and additional fractures were compared between the groups of patients with and without CVI using univariate analyses. In addition, a multivariate logistic regression model was fit to identify risk factors for CVI in this cohort. All two-sided p values < 0.05 were considered statistically significant. Out of 29,398 patients who qualified for the study, only 398 (1.4%) patients sustained a CVI. There were significant differences (p < 0.001) identified between the groups regarding sex, race, mechanism of injury, occurrence of c-spine fracture, and of Le Fort II and III fractures in the univariate analysis. The risk factors identified by the multiple logistic regression model echoed these results and showed that female gender, injuries due to motorcycle, motor vehicle crashes and the presence of a cervical spine or Le Fort fracture were all associated with the occurrence of CVI (p < 0.05). The patients with mandible fracture who were female and sustained a high impact blunt force mechanism had a significantly higher risk of CVI. These high-risk patients should be screened for CVI at the time of initial evaluation.