D141. Analyzing Epidemiology and Hospital Course Outcomes of Lefort Fractures: A National Pediatric Trauma Database Study

PURPOSE: This study analyzes the epidemiology of pediatric LeFort fractures and assesses the incidence of concomitant injuries and acute-level hospital course using the largest, national pediatric facial trauma database to date. METHODS: Pediatric midface and LeFort fractures from 2016-2019 were identified in the National Trauma Data Bank. Descriptive analyses of LeFort compared to non-LeFort midface fractures were performed. Multivariable regression assessed whether LeFort fractures were risk factors for ICU admission, intracranial injury, cervical spine (C-spine) fracture, tracheostomy, and mortality. RESULTS: A total of 1,489 patients with LeFort fractures were identified. There were 520 LeFort I, 632 LeFort II, and 609 LeFort III fractures. Fracture incidence increased with age, with <10% occurring in patients <6 years old. LeFort fractures showed higher rates of concomitant intracranial injury (p<0.001), ICU admission (p<0.001), C-spine fracture (p<0.001), and tracheostomy (p<0.001). Incidence of all the above increased with higher-grade LeFort fractures. LeFort III fractures had higher rates of mortality than non-LeFort midface fractures(7.6% vs 3.2%). Multivariable regression showed that all LeFort patterns were independent risk factors for tracheostomy and ICU admission, but only LeFort I for C-spine fractures. CONCLUSION: The incidence of LeFort fractures appears to increase with age. Higher category LeFort fractures are associated with greater morbidity.