Skip to main content

Advertisement

SpringerLink
Log in

Changes in hospital admissions for facial fractures during and after COVID 19 pandemic: national multicentric epidemiological analysis on 2938 patients

  • Research
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Purpose

The objective of this multicenter study was to examine the differences in maxillo-facial fractures epidemiology across the various phases of the SARS-CoV-2 pandemic.

Methods

This is a retrospective study on patients who underwent surgery for facial bone fractures in 18 maxillo-facial surgery departments in Italy, spanning from June 23, 2019, to February 23, 2022. Based on the admission date, the data were classified into four chronological periods reflecting distinct periods of restrictions in Italy: pre-pandemic, first wave, partial restrictions, and post-pandemic. Epidemiological differences across the groups were analysed.

Results

The study included 2938 patients. A statistically significant difference in hospitalization causes was detected between the pre-pandemic and first wave groups (p = 0.005) and between the pre-pandemic and partial restriction groups (p = 0.002). The differences between the pre- and post-pandemic groups were instead not significant (p = 0.106). Compared to the pre-pandemic period, the number of patients of African origin was significantly higher during the first wave and the post-pandemic period. No statistically significant differences were found across the periods concerning gender, age, fracture type, treatment approach, and hospital stay duration

Conclusions

The COVID-19 pandemic brought about significant changes in fracture epidemiology, influenced by the restrictive measures enforced by the government in Italy. Upon the pandemic’s conclusion, the fracture epidemiology returned to the patterns observed in the pre-pandemic period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Marzia Petrocelli has full access to data included in this manuscript

References

  1. Dawoud BES, Alderson L, Khan U et al (2022) The effect of lockdown during SARS-CoV-2 pandemic on maxillofacial injuries in a level I trauma centre: a comparative study. Oral Maxillofac Surg 26:463–467

    Article  PubMed  Google Scholar 

  2. Spallaccia F, Vellone V, Colangeli W, De Tomaso S (2022) Maxillofacial fractures in the province of Terni (Umbria, Italy) in the last 11 tears: impact of COVID-19 pandemic. J Craniofac Surg 33:e853–e858

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ludwig DC, Nelson JL, Burke AB, Lang MS, Dillon JK (2021) What is the effect of COVID-19-related social distancing on oral and maxillofacial trauma? J Oral Maxillofac Surg 79:1091–1097

    Article  PubMed  Google Scholar 

  4. Salzano G, Dell'Aversana Orabona G, Audino G et al (2021) Have there been any changes in the epidemiology and etiology of maxillofacial trauma during the COVID-19 pandemic? An Italian Multicenter Study. J Craniofac Surg 32:1445–1447

    Article  PubMed  Google Scholar 

  5. de Boutray M, Kün-Darbois JD, Sigaux N et al (2021) Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study. Int J Oral Maxillofac Surg 50:750–755

    Article  PubMed  Google Scholar 

  6. Giovannetti F, Lupi E, Di Giorgio D, Scarsella S, Oliva A, Di Fabio D et al (2022) Impact of COVID19 on maxillofacial fractures in the province of L’Aquila, Abruzzo, Italy. Review of 296 patients treated with statistical comparison of the two-year pre-COVID19 and COVID19. J Craniofac Surg 33:1182–1184

    Article  PubMed  PubMed Central  Google Scholar 

  7. Pappachan B, Alexander M (2012) Biomechanics of cranio-maxillofacial trauma. J Maxillofac Oral Surg 11:224–230

    Article  PubMed  Google Scholar 

  8. Agresti A (2007) Categorical data analysis, 3rd edn. John Wiley & Sons Inc., Hoboken

  9. Sbordone C, Barca I, Petrocelli M et al (2018) The influence of socioeconomic factors on the epidemiology of maxillofacial fractures in southern Italy. J Craniofac Surg 29:1049–2275

    Article  Google Scholar 

  10. Boffano P, Kommers SC, Karagozoglu KH, Forouzanfar T (2014) Aetiology of maxillofacial fractures: a review of published studies during the last 30 years. Br J Oral Maxillofac Surg 52:901–906

    Article  PubMed  Google Scholar 

  11. Bonavolontà P, Dell’aversana Orabona G, Abbate V, Vaira LA, Lo Faro C, Petrocelli M et al (2017) The epidemiological analysis of maxillofacial fractures in Italy: the experience of a single tertiary center with 1720 patients. J Craniomaxillofac Surg 45:1319–1326

    Article  PubMed  Google Scholar 

  12. Brasileiro BF, Passeri LA (2006) Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Radiol Endod 102:28–34

    Article  Google Scholar 

  13. Gassner R, Tuli T, Hachi O, Rudisch A, Ulmer H (2003) Cranio-maxillofacial trauma: a 10 year review of 9543 cases with 21067 injuries. J Craniomaxillofac Surg 31:51–61

    Article  PubMed  Google Scholar 

  14. Iida S, Kogo M, Sugiura T, Mima T, Matsuya T (2001) Retrospective analysis of 1502 patients with facial fractures. Int J Oral Maxillofac Surg 30:286–290

    Article  CAS  PubMed  Google Scholar 

  15. Eggensperger N, Smolka K, Scheiddegger B, Zimmermann H, Hzuka T (2007) A 3-year survey of assault- related maxillofacial fractures in central Switzerland. J Craniomaxillofac Surg 35:161–167

    Article  PubMed  Google Scholar 

  16. Cornelius CP, Kunz C, Neff A, Kellman RM, Prein J, Audigè L (2014) The comprehensive AOCMF Classification System: fracture case collection, diagnostic imaging work up, AOCOIAC iconography and coding. Craniomaxillofac Trauma Reconstr 7:S131–S135

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gourishetti SC, Waghmarae S, Shikara M, Justicz N, Vakharia K (2023) Facial trauma management during the Coronavirus Disease 2019 pandemic. J Craniofac Surg 34:955–958

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kasem A, Redenski I, Oren D, Zoabi A, Srouji S, Kablan F (2022) Decline in maxillofacial injuries during the pandemic: The Hidden Face of COVID-19. J Clin Med 12:128

    Article  PubMed  PubMed Central  Google Scholar 

  19. Tipirneni KE, Gemmiti A, Arnold MA, Suryadevara A (2022) Facial trauma during the COVID-19 pandemic. Craniomaxillofac Trauma Reconstr 15:318–324

    Article  PubMed  Google Scholar 

  20. Nhongo SS, Sklavos A, Lee K, Chan STF, Austin S (2023) The changing face of maxillofacial trauma during the 2020 COVID-19 lockdowns in Melburne. Australia Oral Maxillofac Surg 27:125–130

    Article  PubMed  Google Scholar 

  21. Haapanen A, Furuholm J, Uittamo J, Snall J (2022) Effect of social distancing during the COVID-19 pandemic on the occurrence of maxillofacial fractures in a Finnish tertiary trauma centre. Acta Odontol Scand 80:157–160

    Article  CAS  PubMed  Google Scholar 

  22. Boom LJ, Wolvius EB, Rozeboom AVJ (2022) Impact of COVID-19 lockdown on incidence of maxillofacial fractures: a retrospective analysis. Adv J Oral Maxillofac Surg 6:100289

    Article  Google Scholar 

  23. Canzi G, De Ponti E, Corradi F, Bini R, Novelli G, Bozzetti A, Sozzi D (2020) Epidemiology of maxillo-facial trauma during COVID-19 lockdown: reports from the Hub Trauma Center in Milan. Craniomaxillofac Trauma Reconstr 14:277–283

    Article  PubMed  PubMed Central  Google Scholar 

  24. Shaik E, Ahmed S (2022) An overview of the impact of COVID-19 on road traffic safety and travel behavior. Transp Eng 9:10119

    Google Scholar 

  25. Yasin YJ, Grivna M, Abu-Zidan FM (2021) Global impact of COVID-19 pandemic on road traffic collisions. World J Emerg Surg 16:51

    Article  PubMed  PubMed Central  Google Scholar 

  26. Sekadakis M, Katrakazas K, Michelaraki E, Kehagia F, Yannis G (2021) Analysis of the impact of COVID-19 on collisions, fatalities and injuries using time series forecasting: the case of Greece. Accid Anal Prev 162:106391

    Article  PubMed  PubMed Central  Google Scholar 

  27. Doulabi S, Hassan HM (2023) Near-term impact of COVID-19 pandemic on seniors’ crash size and severity. Accid Anal Prev 185:107037

    Article  PubMed  PubMed Central  Google Scholar 

  28. Patwary AL, Khattak AJ (2023) Crash harm before and during the COVID-19 pandemic: evidence for spatial heterogeneity in Tennessee. Accid Anal Prev 183:106988

    Article  PubMed  PubMed Central  Google Scholar 

  29. Pereira MCP, Fernandes JCH, Fernandes GVO, Nor F, Marques T, Couto P (2023) Impact of the COVID-19 pandemic period on patients with head and neck carcinoma: a systematic review. Diseases 11:61

    Article  PubMed  PubMed Central  Google Scholar 

  30. COVIDSurg Collaborative, GlobalSurg Collaborative (2021) Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia 76:748–758

    Article  Google Scholar 

  31. COVIDSurg Collaborative, GlobalSurg Collaborative (2022) SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study. Anaesthesia 77:28–39

    Article  Google Scholar 

  32. ISTAT migratory flow report 2022. http://www.istat.it. Accessed on: 03 May 2023

  33. Goodfellow M, Burns A (2019) Relation between facial fractures and socioeconomic deprivation in the north east of England. Br J Oral Maxillofac Surg 57:255–259

    Article  CAS  PubMed  Google Scholar 

  34. De Jager E, Ho YH (2022) Socioeconomic disparities in rates of facial fracture surgeries for women and men at a regional tertiary care centre in Australia. ANZ J Surg 92:1700–1705

    Article  PubMed  PubMed Central  Google Scholar 

  35. Chrcanovic BR (2012) Factors influencing the incidence of maxillofacial fractures. Oral Maxillofac Surg 16:3–17

    Article  PubMed  Google Scholar 

  36. Thiel F, Buechl VCS, Rehberg F, Mojahed A, Daniels JK, Schellong J, Garthus-Niegel S (2022) Changes in prevalence and severity of domestic violence during the COVID-19 pandemic: a systematic review. Front Psych 13:874183

    Article  Google Scholar 

  37. Pathirathna ML, Nandasena HMRKG, Atapattu AMMP et al (2022) Impact of the COVID-19 pandemic on suicidal attempts and death rates: a systematic review. BMC Psychiatry 22:506

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy

    Marzia Petrocelli, Federica Ruggiero & Anna Maria Baietti

  2. Department of Clinical Governance and Quality, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy

    Davide Allegri

  3. Dentistry Unit, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy

    Sebastiano Cutrupi

  4. Maxillo-facial Surgery Unit, University Hospital of Naples “Federico II,”, Naples, Italy

    Giovanni Salzano & Luigi Califano

  5. Maxillo-Facial Surgery Unit, University of Bari “Aldo Moro,”, Bari, Italy

    Fabio Maglitto, Alfonso Manfuso & Chiara Copelli

  6. Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, Magna Graecia University, Catanzaro, Italy

    Ida Barca & Maria Giulia Cristofaro

  7. Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy

    Francesca Galvano

  8. Maxillofacial Surgery Unit, ARNAS Brotzu, Cagliari, Italy

    Valentina Poddi Loche & Paolo Gemini

  9. Pediatric Maxillo-Facial Surgery Unit, Children’s Hospital of Brescia – ASST Spedali Civili, Brescia, Italy

    Karim Tewfik & Dante Burlini

  10. Maxillo-Facial Surgery Unit, ASO Santa Croce e Carle, Cuneo, Italy

    Marco Bernardi & Francesca Antonella Bianchi

  11. Department of Maxillo-Facial Surgery, Spirito Santo Hospital, Pescara, Italy

    Susanna Catanzaro & Giuliano Ascani

  12. Maxillo-Facial Surgery Unit, Marche University Hospital, Ancona, Italy

    Giuseppe Consorti & Paolo Balercia

  13. Maxillo-Facial Surgery Unit, A.R.N.A.S. Civico di Cristina Bonfratelli Hospital, Palermo, Italy

    Andrea Braconi & Calogero Scozzaro

  14. UOC of Maxillofacial Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy

    Luciano Catalfamo, Danilo De Rinaldis & Francesco Saverio De Ponte

  15. Head and Neck Department, Operative Unit of Maxillo-Facial Surgery, San Paolo Hospital of Milan, Milan, Italy

    Filippo Tarabbia, Federico Biglioli & Andrea Biglio

  16. Maxillo-Facial Surgery Unit, Perugia Hospital, Perugia, Italy

    Francesco Giovacchini & Antonio Tullio

  17. Oral and Maxillo-Facial Unit, ASL Teramo – G. Mazzini Hospital, Teramo, Italy

    Antonia Cama & Paolo Di Emidio

  18. Head and Neck Department, University Hospital of Parma, Parma, Italy

    Silvano Ferrari & Giuseppe Perlangeli

  19. Maxillo-Facial Surgery, Surgical Sciences Department, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy

    Maria Beatrice Rossi

  20. Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy

    Andrea Biglio, Giacomo De Riu & Luigi Angelo Vaira

  21. Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy

    Luigi Angelo Vaira

Authors
  1. Marzia Petrocelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Federica Ruggiero
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Davide Allegri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sebastiano Cutrupi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anna Maria Baietti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovanni Salzano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fabio Maglitto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alfonso Manfuso
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Chiara Copelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ida Barca
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Maria Giulia Cristofaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Francesca Galvano
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Valentina Poddi Loche
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Paolo Gemini
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Karim Tewfik
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Dante Burlini
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Marco Bernardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Francesca Antonella Bianchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Susanna Catanzaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Giuliano Ascani
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Giuseppe Consorti
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Paolo Balercia
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Andrea Braconi
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Calogero Scozzaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Luciano Catalfamo
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. Danilo De Rinaldis
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Francesco Saverio De Ponte
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Filippo Tarabbia
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. Federico Biglioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Francesco Giovacchini
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. Antonio Tullio
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. Antonia Cama
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. Paolo Di Emidio
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. Silvano Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  35. Giuseppe Perlangeli
    View author publications

    You can also search for this author in PubMed Google Scholar

  36. Maria Beatrice Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  37. Andrea Biglio
    View author publications

    You can also search for this author in PubMed Google Scholar

  38. Giacomo De Riu
    View author publications

    You can also search for this author in PubMed Google Scholar

  39. Luigi Califano
    View author publications

    You can also search for this author in PubMed Google Scholar

  40. Luigi Angelo Vaira
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Marzia Petrocelli: study conception, methodology, writing the original draft, reviewing the final draft, final approval. Federica Ruggiero: study conception, methodology, reviewing the final draft, final approval. Davide Allegri: statistical analysis, writing the original draft, reviewing the final draft, final approval. Sebastiano Cutrupi: statistical analysis, writing the original draft, reviewing the final draft, final approval. Anna Maria Baietti: supervision, reviewing the final draft, final approval. Giovanni Salzano, Fabio Maglitto, Alfonso Manfuso, Chiara Copelli, Ida Barca, Maria Giulia Cristofaro, Francesca Galvano, Valentina Poddi Loche, Paolo Gemini, Karim Tewfik, Dante Burlini, Marco Bernardi, Francesca Antonella Bianchi, Susanna Catanzaro, Giuliano Ascani, Giuseppe Consorti, Paolo Balercia, Andrea Braconi, Calogero Scozzaro, Luciano Catalfamo, Danilo De Rinaldis, Francesco Saverio De Ponte, Filippo Tarabbia, Federico Biglioli, Francesco Giovacchini, Antonio Tullio, Antonia Cama, Paola Di Emidio, Silvano Ferrari, Giuseppe Perlangeli, Maria Beatrice Rossi, Andrea Biglio: data collection, data curation, reviewing the final draft, final approval. Giacomo De Riu, Luigi Califano: supervision, reviewing the final draft, final approval. Luigi Angelo Vaira: supervision, literature review, writing the original draft, reviewing the final draft, final approval.

Corresponding author

Correspondence to Luigi Angelo Vaira.

Ethics declarations

Ethics approval

The study was approved by the CEAVEC Ethical Committee Board (n.192-2022-OSS-AUSLBO) and was carried out in accordance with the ethical principles of the Declaration of Helsinki.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1

(DOCX 23 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Petrocelli, M., Ruggiero, F., Allegri, D. et al. Changes in hospital admissions for facial fractures during and after COVID 19 pandemic: national multicentric epidemiological analysis on 2938 patients. Oral Maxillofac Surg (2023). https://doi.org/10.1007/s10006-023-01201-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10006-023-01201-2

Keywords

Search

Navigation