Factors influencing trends in trauma-associated orbital cavity reconstruction procedures and time delay: New Zealand national data 2000

Abstract

Aim

Surgical reconstructions of orbital fractures due to trauma are increasing worldwide. This study identifies characteristics of patients facing such procedures, possible causes for increasing trends, and factors associated with the duration from trauma to surgical procedures.

Methods

Trauma-related orbital reconstruction procedures in New Zealand over a 15-year period were identified from Ministry of Health hospital discharge data. Age-standardised rates for each year and age-specific rates for each gender were calculated using age, sex and year-specific population data from New Zealand population censuses. The contribution of these procedures to total trauma-related maxillofacial procedures was assessed. Descriptive statistics were used to identify demographic, trauma-related, and procedure-related characteristics associated with higher frequency and increasing trends. Characteristics independently associated with time delay from trauma to surgery were identified by multivariable Cox regression modelling.

Results

Orbital procedures are most common among males and the young to middle aged, and trends in frequency and rates of procedures are sharply increasing outnumbering other types of trauma-related maxillofacial procedures, with interpersonal violence being a major contributor to this increase. Younger age and higher number of injuries are associated with less time delay from injury to procedure while Asian ethnicity, motor vehicle accidents, non-maxillofacial primary diagnoses, and higher number of medical comorbidities are associated with longer delay.

Conclusion

The first three findings are consistent with international literature, and could be considered by policy makers when deriving preventive measures. The findings related to time delay are new and could contribute information towards forming clinical guidelines if similar patterns were identified elsewhere.

Keywords

Orbital cavity reconstruction orbital fracture surgeries delay from injury to surgery

Get full access to this article

View all access options for this article.

References

Kieser

Stephenson

Liston

et al.

Serious facial fractures in New Zealand from 1979 to 1988. Int J Oral Maxillofac Surg 2002; 31: 206–209.

Lee

Antoun

. Zygomatic fractures presenting to a tertiary trauma centre, 1966–2006. New Zealand Dental J 2009; 105: 4–7.

Lee

. Global trends in maxillofacial fractures. Craniomaxillofacial Trauma Reconstuct 2012; 5: 213–222.

Kraft

Abermann

Stigler

et al.

Craniomaxillofacial trauma: synopsis of 14654 cases with 35129 injuries in 15 years. Craniomaxillofacial Trauma Reconst 2012; 5: 41–50.

Snape

. Angry young men, interpersonal violence, alcohol, and broken faces. New Zealand Med J 2005; 118: 1–2.

Lee

Snape

Steenberg

et al.

Comparison between interpersonal violence and motor vehicle accidents in the aetiology of maxillofacial fractures. ANZ J Surg 2007; 77: 695–698.

Tong

Kumar

Kok

et al.

Patterns of Maxillofacial fracture presentation in Dunedin from 2000 to 2005. New Zealand Dental J 2010; 106: 16–19.

Adsett

Thomson

Kieser

et al.

Patterns and trends in facial fractures in New Zealand between 1999 and 2009. New Zealand Dental J 2013; 109: 142–147.

Kypri

Voas

Langley

et al.

Minimum purchase age for alcohol and traffic crash injuries among 15 to 19 year olds in New Zealand. Am J Public Health 2006; 96: 126–131.

10.

Selvarajah K. Interpersonal violence related oral and maxillofacial trauma and change in legal drinking age. Masters Thesis, University of Otago, New Zealand, 2007.

11.

Lee

Snape

. Role of alcohol in maxillofacial fractures. New Zealand Med J 2008; 121: 15–23.

12.

Love

Ponnambalam

. Dental and maxillofacial skeletal injuries seen at the University of Otago School of Dentistry, New Zealand 2000–2004. Dental Traumatol 2008; 24: 170–176.

13.

Thomson

Stephenson

Kieser

et al.

Dental and maxillofacial injuries among older New Zealanders during the 1990s. Int J Oral Maxillofac Surg 2003; 32: 201–205.

14.

Jordan

Allen

White

. Intervention within days for some orbital floor fractures: the white-eyed blowout. Ophthal Plast Reconstr Surg 1998; 14: 379–390.

15.

Joshi

Kassira

Thaller

. Overview of paediatric orbital fractures. J Craniofac Surg 2011; 22: 1330–1332.

16.

Sires

Stanley

Wash

et al.

Oculocardiac reflex caused by orbital floor trapdoor fracture: an indication for urgent repair. Arch Ophthalmol 1998; 116: 955–956.

17.

Burnstine

. Clinical recommendations for repair of isolated orbital floor fractures, an evidence-based analysis. Ophthalmology 2002; 109: 1207–1213.

18.

Kwon

Moon

Kwon

. The differences of blowout fracture of the inferior orbital wall between children and adults. Arch Otolaryngol Head Neck Surg 2005; 131: 723–727.

19.

MOH. National Minimum Dataset (Hospital Events) data dictionary, http://www.health.govt.nz/publication/national-minimum-dataset-hospital-events-data-dictionary (2015, accessed 10 June 2016).

20.

NCCH. Australian Classification of health interventions (ACHI). Tabular list of interventions, 6th ed. Sydney, Australia: National Centre for Classification in Health, 2008.

21.

NCCH. The international statistical classification of diseases and related health problems. 10th ed. Australian modification (ICD-10-AM). Sydney, Australia: National Centre for Classification in Health, 2002.

22.

MOH. Selected morbidity data for publicly funded hospitals 1 July 2002 to 30 June 2003. Wellington, New Zealand: Ministry of Health, http://www.health.govt.nz/publication/selected-morbidity-data-publicly-funded-hospitals-1-july-2002-30-june-2003 (accessed 30 November 2016).

23.

MOH. Selected privately funded morbidity data 2002. New Zealand Health Information Service, Wellington, New Zealand: Ministry of Health, 2006. , http://www.moh.govt.nz/notebook/nbbooks.nsf/0/2B90B358D47BE65B4C256621000E618A/$file/privatemorbidity2002.pdf (accessed 30 November 2016).

24.

SNS. Statistics New Zealand. Statistical standard for ethnicity 2005, Wellington, New Zealand: SNS, 2005.

25.

Statistics New Zealand. 2015. Census of population and dwellings, http://nzdotstat.stats.govt.nz/wbos/Index.aspx?DataSetCode=TABLECODE7501# (accessed 15 December 2015).

26.

Bland

Altman

. Statistics notes, the logrank test. BMJ 2004; 328: 1073–1073.

27.

Cox

Oakes

. Analysis of survival data, New York, NY: Chapman & Hall, 1984.

28.

Kaplan

Meier

. Nonparametric estimation from incomplete observations. J Am Statist Assn 1958; 53: 457–481.

29.

Williams

. A note on robust variance estimator for cluster-correlated data. Biometrics 2000; 56: 645–646.

30.

Pregibon

. Goodness of link tests for generalized linear models. Appl Stat 1980; 29: 15–24.

31.

Stata®. Stata statistical software. Release 13. College Station, TX: StataCorp LP, 2012.

32.

Langley

Chalmers

. Coding the circumstances of injury: ICD-10 a step forward or backwards? Inj Prev 1999; 5: 247–253.

33.

Gjertsen

Bruzzone

Vollrath

et al.

Comparing ICD-9 and ICD-10: the impact on intentional and unintentional injury mortality statistics in Italy and Norway. Injury 2013; 44: 132–138.

34.

MOH Factsheet: Short stay emergency department events. Wellington: Ministry of Health, http://www.health.govt.nz/publication/factsheet-short-stay-emergency-department-events (2015, accessed 10 June 2016).

35.

Beek

GJV

Merkx

. Changes in the pattern of fractures of the maxillofacial skeleton. Int J Oral Maxillofac Surg 1999; 28: 424–428.

36.

Gosau

Schoneich

Draenert

et al.

Retrospective analysis of orbital floor fractures-Complications, outcome, and review of literature. Clin Oral Invest 2011; 15: 305–313.

37.

Folkestad

Granstrom

. A prospective study of orbital fracture sequelae after change of surgical routines. J Oral Maxillofac Surg 2003; 61: 1038–1044.

38.

Folkestad

Westin

. Long-term sequelae after surgery for orbital floor fractures. Otolaryngol Head Neck Surg 1999; 120: 914–921.

39.

Moore

Smit

Colquhoun

et al.

Maxillofacial fractures at Waikato Hospital, New Zealand: 2004 to 2013. New Zealand Medl J 2015; 128: 96–102.

40.

Folkestad

Aberg-Bengtsson

Granstrom

. Recovery from orbital floor fractures: a prospective study of patients’ and doctors’ experiences. Int J Oral Maxillofac Surg 2006; 35: 499–505.

41.

Davie

Langley

Samaranayaka

et al.

Accuracy of injury coding under ICD-10-AM for New Zealand public hospital discharges. Injury Prevent 2008; 14: 319–323.

42.

Cassidy

Carroll

Cote

et al.

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Engl J Med 2000; 342: 1179–1186.

43.

Littleton

Cameron

Poustie

et al.

The association of compensation on longer term health status for people with musculoskeletal injuries following road traffic crashes: emergency department inception cohort study. Injury 2011; 42: 927–933.

44.

Murgatroyd

Cameron

Harris

. Understanding the effect of compensation on recovery from severe motor vehicle crash injuries: a qualitative study. Inj Prev 2011; 17: 222–227.

Factors influencing trends in trauma-associated orbital cavity reconstruction procedures and time delay: New Zealand national data 2000–2014

Abstract

Aim

Methods

Results

Conclusion

Keywords

Get full access to this article

References