Cranio-maxillofacial injuries in victims of interpersonal violence
BACKGROUND: Recent research has indicated an increase in the severity of head injuries in Switzerland. The aim of the present study was to describe the epidemiological features of cranio-maxillofacial (CMF) injuries due to interpersonal violence in patients at the Bern University Hospital Emergency Department (ED), based on injury patterns.
METHODS: Retrospective analysis was performed on data collected during an 11-year period between 1 January 2000 and 31 December 2010 covering 1,585 patients. A distinction was drawn between neurocranial and maxillofacial injuries, and two time periods (2000–2004 and 2005–2010) were compared.
RESULTS: The patients’ median age at the time of admission was 26 years (range 12–82), and 1,473 of 1,585 patients (92.9%) were males. Referrals increased from an annual average of 119.6 in 2000–2004 to 164.5 in 2005–2010 (p <0.001). Severe neurocranial injuries doubled in number – from an annual average of 4.2 in 2000–2004 to 8.5 in 2005–2010 (p = 0.010). Maxillofacial injuries seen in the ED increased from an average of 163.6 per year in 2000–2004 to 247.8 in 2005–2010 (p <0.001), and the number of maxillofacial injuries per patient increased from 1.37 to 1.51 (p = 0.015).
CONCLUSIONS: Cranio-maxillofacial (CMF) injuries chiefly affect young people, and thus impose a heavy economic burden on society. Synergies are possible between the implementation of violence prevention strategies and other prevention objectives in every age group and intervention area.
- Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. The World Report on Violence and Health. Geneva: World Health Organization; 2002.
- Waters H, Hyder A, Rajkotia Y, Basu S, Rehwinkel JA, Butchart A. The Economic Dimensions of Interpersonal Violence. Geneva: World Health Organization; 2004.
- Exadaktylos AK, Häuselmann S, Zimmermann H. Are times getting tougher? A six year survey of urban violence-related injuries in a Swiss university hospital. Swiss Med Wkly. 2007;137:525–30.
- Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, editors. Global Burden of Disease and Risk Factors. Washington (DC): World Bank; 2006.
- Statistisches Lexikon der Schweiz. Swiss Federal Statistical Office; [cited 2012 28 August]; Available from: http://www.bfs.admin.ch.
- Waters HR, Hyder AA, Rajkotia Y, Basu S, Butchart A. The costs of interpersonal violence – an international review. Health Policy. 2005;73:303–15.
- Exadaktylos A, Jonas C, Eggli S, Kohler HP, Zimmermann H. Violence in Bern. Swiss Med Wkly. 2001;131:527.
- Exadaktylos AK, Evangelisti A, Anghern F, Keller U, Dopke K, Ringger A, et al. Measuring attitudes, behaviours, and influences in inner city victims of interpersonal violence (VIVs) – a Swiss emergency room pilot study. J Trauma Manag Outcomes. 2010;4:8.
- Schreyer N, Carron PN, Demartines N, Yersin B. Stab wounds in a Swiss emergency department: a series of 80 consecutive cases. Swiss Med Wkly. 2010;140:w13058.
- Rosenberg ML, Butchart A, Mercy J, Narasimhan V, Waters H, Marshall MS. Interpersonal Violence. In: Jamison D, Breman J, Measham A, editors. Disease Control Priorities in Developing Countries. 2nd ed. Washington (DC): World Bank; 2006.
- Miller TR, Fisher DA, Cohen MA. Costs of juvenile violence: policy implications. Pediatrics. 2001;107:1–7.
- Brand S, Price R. The economic and social costs of crime. 2000 [cited 2012 28 August]; Available from: http://webarchive.nationalarchives.gov.uk/20110218135832/rds.homeoffice.gov.uk/rds/pdfs/hors217.pdf
- Eggensperger N, Smolka K, Scheidegger B, Zimmermann H, Iizuka T. A 3-year survey of assault-related maxillofacial fractures in central Switzerland. J CranioMaxillofac Surg. 2007;35(3):161–7.
- Gassner R, Tuli T, Hachl O, Rudisch A, Ulmer H. Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J CranioMaxillofac Surg. 2003;31:51–61.
- Lee KH. Interpersonal violence and facial fractures. J Oral Maxillofac Surg. 2009;67:1878–83.
- Baier D, Pfeiffer C, Simonson J, Rabold S. Jugendliche in Deutschland als Opfer und Täter von Gewalt. Hannover: Kriminologisches Forschungsinstitut Niedersachsen; 2009.
- Hahn R, Fuqua-Whitley D, Wethington H, Lowy J, Crosby A, Fullilove M, et al.; Task Force on Community Preventive Services. Effectiveness of universal school-based programs to prevent violent and aggressive behaviour: a systematic review. Am J Prev Med. 2007;33(2 Suppl):S114–29.
- Prevention of youth violence [cited 2012 28 August]; http://www.ekm.admin.ch/de/dokumentation/doku/mat_jugendgewalt_d.pdf
- Alcohol consumption and its resulting costs. Bern: Swiss Alcohol Board; [cited 2012 28 August]; Available from: http://www.eav.admin.ch/themen/00593/00597/index.html?lang=en.