Craniofacial Trauma Is Associated with Significant Psychosocial Morbidity One Year Post-Injury

Publication date: Available online 20 August 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Kenleigh R. McMinn, Monica Bennett, Mark B. Powers, Michael L. Foreman, Likith V. Reddy, Ann Marie Warren

Abstract

Purpose

The face and head play critical roles in one's sense of self and body image; as such, facial, head, and scalp injuries and potential associated disfigurement may lead to particular difficulties in coping. This study examined the psychosocial outcomes of patients with craniofacial (CF) trauma one year post-injury and compare these outcomes to those of other traumatically injured patients who did not sustain such injuries. It was hypothesized that participants in the CF injury group would have worse outcomes than those without CF trauma.

Methods

This prospective longitudinal study included patients ≥18 years of age admitted to the trauma service of a Level I Trauma Center for ≥ 24 hours. Demographic and injury-related variables were collected. CF injury was determined by ICD-9 codes. Outcomes were measured at baseline and at 12 months and included depression, posttraumatic stress disorder (PTSD), alcohol use, and pain severity. Paired t-tests and logistic regression were used for analysis.

Results

Fifteen percent (n=35) of the study sample (N=230) had CF injuries. Those with CF injuries had lower income, higher injury severity, and higher ICU admission rates. The CF and non-CF trauma groups did not differ in rates of depression or PTSD at either time point. However, CF trauma participants had higher odds of risky alcohol use than non-CF traumas at baseline, and lower odds of a higher pain severity score at baseline and 12 months.

Conclusions

The groups did not differ in terms of depression and PTSD. However, the rates of depression, PTSD, alcohol use, and physical pain were higher than expected for both groups. Given the high rate of psychological morbidity found following CF trauma, individuals with these injuries should be screened for symptoms early after injury and provided with resources for treatment.

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