Do demographic and socioeconomic factors influence the management of nasal bone fractures?

OBJECTIVE

The study purpose was to measure the association between demographic and socioeconomic factors in the management of nasal bone fractures.

STUDY

DESIGN

This was a retrospective cohort study of 995 adult patients presenting to John H. Stroger Jr. Hospital of Cook County from 2016 to 2024 with nasal bone fractures. The primary outcome variable was operative versus non-operative management. Data analysis was performed using chi-squared, Pearson's correlation, Mann-Whitney U tests, and multivariate logistic regressions.

RESULTS

Females were more frequently scheduled for follow-up (P = .015). Patients who attended follow-up (P < .001) and underwent surgery (P = .01) were younger on average. Detainees, or incarcerated/jailed patients, were more likely to attend follow-up (P < .001). High median household incomes and non-Chicago zip codes were associated with lower follow-up rates (P = .023). In bivariate analysis, Black/African American patients were less likely to undergo surgery than White patients (P = .035). In the subgroup, higher median household incomes were more likely to undergo surgery (P = .031).

CONCLUSIONS

Demographic and socioeconomic factors are associated with the management of nasal bone fractures, including likelihood of operative intervention. Surgeons should consider the role that these factors and unconscious bias play in treatment.