Can a Facial Injury Severity Scale Be Used to Predict the Need for Surgical Intervention and Time of Hospitalization?

PURPOSE: We aimed to evaluate whether the Facial Injury Severity Scale (FISS), proposed by Bagheri et al in 2006, can predict intervention needs in the operating room (OR), length of hospital stay, and need for support by other specialties.

PATIENTS AND

METHODS

Data were collected from the medical records of trauma patients from a public tertiary hospital between January 2009 and December 2015, related to age, gender, comorbidities, habits, history of maxillofacial trauma, etiology, and presence and location of fractures and lacerations, in addition to type of treatment performed and period of hospitalization. A score was applied to each patient according to the FISS. Adjusted multinomial logistic regression models were generated, and all analyses were performed with the SPSS statistical package (version 17.0; IBM, Armonk, NY).

RESULTS

The final sample consisted of 469 medical records. The mean age was 31.38 ± 14.13 years. Traffic accidents were the most frequent cause of trauma (41.2%), followed by interpersonal violence (29.4%). The most commonly fractured bone was the mandible (32.9%), and the mandibular angle was the most affected region (29.0%). Reports of alcohol intake resulted in a 100% increase in the need for treatment of fractures in the OR. Patients with FISS scores greater than 5 presented with 18 times the chance of needing intervention in the OR and a greater possibility of hospitalization longer than 3 days (P < .01). The mean length of hospital stay was 8.14 ± 6.02 days, with a statistically significantly longer hospitalization period for smokers (P < .0001). Patients with any type of comorbidity were more likely to require support from other specialties (P = .022), and those with FISS scores greater than 5 were 6.6 times more likely to need this support (P < .0001).

CONCLUSIONS

Higher FISS scores may predispose patients to a longer hospitalization time, a greater chance of undergoing surgical procedures, and a greater need for follow-up by other medical specialties.