Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data

Purpose To compare military with civilian gunshot wounds (GSWs) in the maxillofacial region in order to establish differences in presentation, morbidity, and surgical management. Materials and Methods A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillo...

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Veröffentlicht in:Journal of oral and maxillofacial surgery 2016-04, Vol.74 (4), p.795.e1-795.e7
Hauptverfasser: Guevara, Carlo, DDS, MD, Pirgousis, Phillip, MD, DMD, Steinberg, Barry, MD, DDS, PhD
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container_end_page 795.e7
container_issue 4
container_start_page 795.e1
container_title Journal of oral and maxillofacial surgery
container_volume 74
creator Guevara, Carlo, DDS, MD
Pirgousis, Phillip, MD, DMD
Steinberg, Barry, MD, DDS, PhD
description Purpose To compare military with civilian gunshot wounds (GSWs) in the maxillofacial region in order to establish differences in presentation, morbidity, and surgical management. Materials and Methods A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillofacial surgery operating room census and hospital trauma registry were both reviewed to identify maxillofacial GSW cases from 2005 through 2011. Military GSW data (2005 through 2011) were obtained from the US Department of Defense (DOD). The predictor variables were civilian versus military GSW events. The outcome variables of interest included the region of the face involved, race, gender, death during admission, hospital length of stay, and number of days in the intensive care unit (ICU). Descriptive statistics were computed. Results The sample was divided into military maxillofacial GSWs (n = 412) and civilian maxillofacial GSWs (n = 287 treated of 2,478 presented). A significant difference was measured between study groups regarding the region of the face involved ( P  = .0451), gender ( P ≤ .0001), and race ( P ≤ .0001). No significant relationship was measured regarding deaths during admission ( P  = .6510) for either study group. No standard deviation values for hospital length of stay or number of ICU days were provided by the DOD. The mean hospital length of stay for the military group was within the 95% confidence interval of the civilian group findings (6.0-7.6). The mean number of ICU days for the military group was not within the civilian group's 95% confidence interval (1.9-2.9). Conclusions These data showed important differences in anatomic location, gender, and race distribution of maxillofacial GSWs between military and civilian populations. Limited analysis of hospital length of stay and number of ICU days might indicate no meaningful difference in hospital length of stay, although there was a statistical difference in the number of ICU days between the 2 populations. Future research comparing surgical strategies in these 2 environments could assist maxillofacial surgeons in providing optimal care to their patients.
doi_str_mv 10.1016/j.joms.2015.11.007
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Materials and Methods A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillofacial surgery operating room census and hospital trauma registry were both reviewed to identify maxillofacial GSW cases from 2005 through 2011. Military GSW data (2005 through 2011) were obtained from the US Department of Defense (DOD). The predictor variables were civilian versus military GSW events. The outcome variables of interest included the region of the face involved, race, gender, death during admission, hospital length of stay, and number of days in the intensive care unit (ICU). Descriptive statistics were computed. Results The sample was divided into military maxillofacial GSWs (n = 412) and civilian maxillofacial GSWs (n = 287 treated of 2,478 presented). A significant difference was measured between study groups regarding the region of the face involved ( P  = .0451), gender ( P ≤ .0001), and race ( P ≤ .0001). No significant relationship was measured regarding deaths during admission ( P  = .6510) for either study group. No standard deviation values for hospital length of stay or number of ICU days were provided by the DOD. The mean hospital length of stay for the military group was within the 95% confidence interval of the civilian group findings (6.0-7.6). The mean number of ICU days for the military group was not within the civilian group's 95% confidence interval (1.9-2.9). Conclusions These data showed important differences in anatomic location, gender, and race distribution of maxillofacial GSWs between military and civilian populations. Limited analysis of hospital length of stay and number of ICU days might indicate no meaningful difference in hospital length of stay, although there was a statistical difference in the number of ICU days between the 2 populations. Future research comparing surgical strategies in these 2 environments could assist maxillofacial surgeons in providing optimal care to their patients.</description><identifier>ISSN: 0278-2391</identifier><identifier>EISSN: 1531-5053</identifier><identifier>DOI: 10.1016/j.joms.2015.11.007</identifier><identifier>PMID: 26687155</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Adolescent ; Adult ; African Americans - statistics & numerical data ; Child ; Critical Care - statistics & numerical data ; Cross-Sectional Studies ; Dentistry ; European Continental Ancestry Group - statistics & numerical data ; Facial Injuries - epidemiology ; Female ; Florida - epidemiology ; Humans ; Length of Stay - statistics & numerical data ; Male ; Mandibular Injuries - epidemiology ; Maxillofacial Injuries - epidemiology ; Maxillofacial Injuries - mortality ; Military Personnel - statistics & numerical data ; Patient Admission - statistics & numerical data ; Sex Factors ; Soft Tissue Injuries - epidemiology ; Suicide - statistics & numerical data ; Surgery ; United States - epidemiology ; Violence - statistics & numerical data ; Warfare ; Wounds, Gunshot - epidemiology ; Wounds, Gunshot - mortality ; Young Adult]]></subject><ispartof>Journal of oral and maxillofacial surgery, 2016-04, Vol.74 (4), p.795.e1-795.e7</ispartof><rights>American Association of Oral and Maxillofacial Surgeons</rights><rights>2016 American Association of Oral and Maxillofacial Surgeons</rights><rights>Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-7c6aa32540aac986f53f0451f6be90a073198c010a136e8026050f015818eebb3</citedby><cites>FETCH-LOGICAL-c481t-7c6aa32540aac986f53f0451f6be90a073198c010a136e8026050f015818eebb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.joms.2015.11.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26687155$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guevara, Carlo, DDS, MD</creatorcontrib><creatorcontrib>Pirgousis, Phillip, MD, DMD</creatorcontrib><creatorcontrib>Steinberg, Barry, MD, DDS, PhD</creatorcontrib><title>Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data</title><title>Journal of oral and maxillofacial surgery</title><addtitle>J Oral Maxillofac Surg</addtitle><description>Purpose To compare military with civilian gunshot wounds (GSWs) in the maxillofacial region in order to establish differences in presentation, morbidity, and surgical management. Materials and Methods A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillofacial surgery operating room census and hospital trauma registry were both reviewed to identify maxillofacial GSW cases from 2005 through 2011. Military GSW data (2005 through 2011) were obtained from the US Department of Defense (DOD). The predictor variables were civilian versus military GSW events. The outcome variables of interest included the region of the face involved, race, gender, death during admission, hospital length of stay, and number of days in the intensive care unit (ICU). Descriptive statistics were computed. Results The sample was divided into military maxillofacial GSWs (n = 412) and civilian maxillofacial GSWs (n = 287 treated of 2,478 presented). A significant difference was measured between study groups regarding the region of the face involved ( P  = .0451), gender ( P ≤ .0001), and race ( P ≤ .0001). No significant relationship was measured regarding deaths during admission ( P  = .6510) for either study group. No standard deviation values for hospital length of stay or number of ICU days were provided by the DOD. The mean hospital length of stay for the military group was within the 95% confidence interval of the civilian group findings (6.0-7.6). The mean number of ICU days for the military group was not within the civilian group's 95% confidence interval (1.9-2.9). Conclusions These data showed important differences in anatomic location, gender, and race distribution of maxillofacial GSWs between military and civilian populations. Limited analysis of hospital length of stay and number of ICU days might indicate no meaningful difference in hospital length of stay, although there was a statistical difference in the number of ICU days between the 2 populations. Future research comparing surgical strategies in these 2 environments could assist maxillofacial surgeons in providing optimal care to their patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>African Americans - statistics &amp; numerical data</subject><subject>Child</subject><subject>Critical Care - statistics &amp; numerical data</subject><subject>Cross-Sectional Studies</subject><subject>Dentistry</subject><subject>European Continental Ancestry Group - statistics &amp; numerical data</subject><subject>Facial Injuries - epidemiology</subject><subject>Female</subject><subject>Florida - epidemiology</subject><subject>Humans</subject><subject>Length of Stay - statistics &amp; numerical data</subject><subject>Male</subject><subject>Mandibular Injuries - epidemiology</subject><subject>Maxillofacial Injuries - epidemiology</subject><subject>Maxillofacial Injuries - mortality</subject><subject>Military Personnel - statistics &amp; numerical data</subject><subject>Patient Admission - statistics &amp; numerical data</subject><subject>Sex Factors</subject><subject>Soft Tissue Injuries - epidemiology</subject><subject>Suicide - statistics &amp; numerical data</subject><subject>Surgery</subject><subject>United States - epidemiology</subject><subject>Violence - statistics &amp; numerical data</subject><subject>Warfare</subject><subject>Wounds, Gunshot - epidemiology</subject><subject>Wounds, Gunshot - mortality</subject><subject>Young Adult</subject><issn>0278-2391</issn><issn>1531-5053</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0EokvLH-CAfOSSMGPHToIQUrVAadWqB-Bseb2OcHDsxU6q9t_jaAsHDpxmDu89zXyPkFcINQLKt2M9xinXDFDUiDVA-4RsUHCsBAj-lGyAtV3FeI8n5EXOIwCiaOVzcsKk7FoUYkOubvS98z4O2jjt6cUS8o8408swLsnZ_I6e022cDjq5HAONA926O-edDlSHPb0p66zTA_2oZ31Gng3aZ_vycZ6S758_fdt-qa5vLy6359eVaTqcq9ZIrTkTDWht-k4Ogg_QCBzkzvagoeXYdwYQNHJpO2ASBAzlxw47a3c7fkreHHMPKf5abJ7V5LKx3utg45IVtq2UrG94U6TsKDUp5pzsoA7JTeVghaBWhmpUK0O1MlSIqjAspteP-ctusvu_lj_QiuD9UWDLl3fOJpWNs8HYvUvWzGof3f_zP_xjN94FZ7T_aR9sHuOSQuGnUGWmQH1dW1xLRFFCGmz4bxpIlcQ</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Guevara, Carlo, DDS, MD</creator><creator>Pirgousis, Phillip, MD, DMD</creator><creator>Steinberg, Barry, MD, DDS, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160401</creationdate><title>Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data</title><author>Guevara, Carlo, DDS, MD ; Pirgousis, Phillip, MD, DMD ; Steinberg, Barry, MD, DDS, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-7c6aa32540aac986f53f0451f6be90a073198c010a136e8026050f015818eebb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>African Americans - statistics &amp; numerical data</topic><topic>Child</topic><topic>Critical Care - statistics &amp; numerical data</topic><topic>Cross-Sectional Studies</topic><topic>Dentistry</topic><topic>European Continental Ancestry Group - statistics &amp; numerical data</topic><topic>Facial Injuries - epidemiology</topic><topic>Female</topic><topic>Florida - epidemiology</topic><topic>Humans</topic><topic>Length of Stay - statistics &amp; numerical data</topic><topic>Male</topic><topic>Mandibular Injuries - epidemiology</topic><topic>Maxillofacial Injuries - epidemiology</topic><topic>Maxillofacial Injuries - mortality</topic><topic>Military Personnel - statistics &amp; numerical data</topic><topic>Patient Admission - statistics &amp; numerical data</topic><topic>Sex Factors</topic><topic>Soft Tissue Injuries - epidemiology</topic><topic>Suicide - statistics &amp; numerical data</topic><topic>Surgery</topic><topic>United States - epidemiology</topic><topic>Violence - statistics &amp; numerical data</topic><topic>Warfare</topic><topic>Wounds, Gunshot - epidemiology</topic><topic>Wounds, Gunshot - mortality</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guevara, Carlo, DDS, MD</creatorcontrib><creatorcontrib>Pirgousis, Phillip, MD, DMD</creatorcontrib><creatorcontrib>Steinberg, Barry, MD, DDS, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of oral and maxillofacial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guevara, Carlo, DDS, MD</au><au>Pirgousis, Phillip, MD, DMD</au><au>Steinberg, Barry, MD, DDS, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data</atitle><jtitle>Journal of oral and maxillofacial surgery</jtitle><addtitle>J Oral Maxillofac Surg</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>74</volume><issue>4</issue><spage>795.e1</spage><epage>795.e7</epage><pages>795.e1-795.e7</pages><issn>0278-2391</issn><eissn>1531-5053</eissn><abstract>Purpose To compare military with civilian gunshot wounds (GSWs) in the maxillofacial region in order to establish differences in presentation, morbidity, and surgical management. Materials and Methods A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillofacial surgery operating room census and hospital trauma registry were both reviewed to identify maxillofacial GSW cases from 2005 through 2011. Military GSW data (2005 through 2011) were obtained from the US Department of Defense (DOD). The predictor variables were civilian versus military GSW events. The outcome variables of interest included the region of the face involved, race, gender, death during admission, hospital length of stay, and number of days in the intensive care unit (ICU). Descriptive statistics were computed. Results The sample was divided into military maxillofacial GSWs (n = 412) and civilian maxillofacial GSWs (n = 287 treated of 2,478 presented). A significant difference was measured between study groups regarding the region of the face involved ( P  = .0451), gender ( P ≤ .0001), and race ( P ≤ .0001). No significant relationship was measured regarding deaths during admission ( P  = .6510) for either study group. No standard deviation values for hospital length of stay or number of ICU days were provided by the DOD. The mean hospital length of stay for the military group was within the 95% confidence interval of the civilian group findings (6.0-7.6). The mean number of ICU days for the military group was not within the civilian group's 95% confidence interval (1.9-2.9). Conclusions These data showed important differences in anatomic location, gender, and race distribution of maxillofacial GSWs between military and civilian populations. Limited analysis of hospital length of stay and number of ICU days might indicate no meaningful difference in hospital length of stay, although there was a statistical difference in the number of ICU days between the 2 populations. Future research comparing surgical strategies in these 2 environments could assist maxillofacial surgeons in providing optimal care to their patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26687155</pmid><doi>10.1016/j.joms.2015.11.007</doi></addata></record>
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subjects Adolescent
Adult
African Americans - statistics & numerical data
Child
Critical Care - statistics & numerical data
Cross-Sectional Studies
Dentistry
European Continental Ancestry Group - statistics & numerical data
Facial Injuries - epidemiology
Female
Florida - epidemiology
Humans
Length of Stay - statistics & numerical data
Male
Mandibular Injuries - epidemiology
Maxillofacial Injuries - epidemiology
Maxillofacial Injuries - mortality
Military Personnel - statistics & numerical data
Patient Admission - statistics & numerical data
Sex Factors
Soft Tissue Injuries - epidemiology
Suicide - statistics & numerical data
Surgery
United States - epidemiology
Violence - statistics & numerical data
Warfare
Wounds, Gunshot - epidemiology
Wounds, Gunshot - mortality
Young Adult
title Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data
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