(1050) Pediatric Facial Fractures: A TriNetX Database Study Investigating Racial Disparities

Introduction: While less common than in the adult population, pediatric facial trauma remains a significant source of morbidity in pediatric patients. Literature regarding etiology, outcomes, and management of pediatric facial fractures is vast. However, studies investigating the role of racial disparities are limited.

Methods: This was a retrospective cohort study using TriNetX datasets that included patients less than 18 years diagnosed with a facial fracture between January 1, 2014 and January 22, 2024. Outcomes included the mechanism of injury, return emergency department (ED) visits, and medication usage between the African American (AA) and Caucasian populations.

Results: 3,800 facial fractures were isolated including mandibular (n=450), maxillary (n=620), zygomatic (n=290), orbital (n=500), nasal (n=940), and skull base fractures (n=1000). The most common mechanisms of injury were falling (n=790), exposure to inanimate mechanical forces (n=240), pedal rider injury (n=130), and car occupant injured in transport accident (n=150). The age of AA patients who had mandibular (p=0.0058), maxillary (p=0.0226), nasal (p < 0.0001), and skull base (p < 0.0001) fractures was significantly younger than Caucasian patients. AA patients were more likely to sustain mandibular, maxillary, orbital, nasal, and skull base fractures by falling (p < 0.0001;p=0.0001;p < 0.0001;p < 0.0001;p=0.0007) or from exposure to inanimate mechanical forces (p=0.0190;p=0.0276;p=0.0228;p=0.0069;p=0.0029). AA patients were more likely to sustain maxillary, orbital and nasal fractures from a motor vehicle accident (p=0.0276;p=0.0288;p=0.0029). AA patients with maxillary (p=0.0009), zygomatic (p=0.0495), and skull base (p=0.0069) fractures had a greater risk of returning to the ED. AA patients with mandibular fractures had a greater risk of using analgesics (p=0.0339), specifically opioids (p=0.0305) and non-opioids (p=0.0306).

Conclusions: By identifying racial disparities that may impact pediatric facial trauma outcomes, future quality improvement and intervention programs may be designed to address these disparities.