Quantifying the Severity of Facial Trauma in a Bulgarian Cohort Using the Comprehensive Facial Injury Score.

Background/

Objectives

The present investigation was designed and conducted with the aim to evaluate the statistical significance of the Comprehensive Facial Injury (CFI) score in relation to total surgical time (ST), length of hospital stay (LOS), and the presence of head injury in patients with fractures of the maxillofacial skeleton.

Methods

The study includes 332 patients with maxillofacial fractures, a subset of whom also had associated head injuries. The CFI score was calculated for each patient. The Kolmogorov-Smirnov test was applied to assess the distribution of score values within the cohort. The Kruskal-Wallis H test was used to compare ST (minutes), LOS (days), and Glasgow Coma Scale (GCS) scores across different CFI score groups. Statistical significance was defined as p < 0.05.

Results

The majority of the patients were male, at 77.1%, with 22.9% female. The mean age was 36.4 years, with a standard deviation of 19.3 years. Definitive surgical treatment was performed in 58.7% of patients, while the remaining 41.3% were managed conservatively (with closed reduction and external fixation) or received no surgical intervention. A statistically significant association was found between the CFI score and both ST and LOS (p < 0.001). Associated head injury was found in 33 patients or 9.9%. Furthermore, significant correlations were observed between CFI score values and Glasgow Coma Scale scores (p < 0.001) as well as the presence of head injury (p < 0.001).

Conclusions

In conclusion, the CFI score provides a straightforward and comprehensive framework for assessing both operative duration and hospitalization length in patients with maxillofacial trauma. Moderate correlations between the CFI score and all investigated variables support its reliability in assessing trauma severity. The CFI score may therefore be useful in guiding treatment planning and developing standardized clinical protocols. However, its predictive capacity requires further validation in future studies.