Association between maxillofacial fractures and brain injuries in trauma patients: a cross-sectional study in the Kingdom of Saudi Arabia

Introduction: trauma is on the rise in the Kingdom of Saudi Arabia (KSA) due to rapid urbanization and motorization, posing increased risks of traumatic maxillofacial and brain injuries. Given the high morbidity and mortality associated with these injuries, this study aimed to measure the prevalence and associated factors of brain injury among head injury trauma patients. Methods: a cross-sectional study was conducted at the King Khalid hospital and Prince Sultan Centre for Healthcare in Al-Kharj City and the Al Kharj Military Industries Corporation Hospital in Al-Kharj City in the KSA. Multivariable logistic regression modelling was performed to ascertain clinical factors associated with Traumatic Brain Injury (TBI). Results: we included 109 participants aged median 25 and IQR (18-35) years 26.95 ± 14.73 years. Most participants were males (92.7%, n = 101) and 68% (n = 75) had Saudi nationality. About 47.7% (n = 52) had maxillofacial/skull fractures and 44% (n = 48) had TBI. Participants in the age group of 31-40 years experienced a greater risk of TBI than those in the age group of 10 or less years (aOR: 6.2, CI = 1.1p = 0.041). Participants with parietal bone fractures (aOR = 23.1, CI = 3.0 - 181.3, p = 0.003) and frontal bone fractures (aOR = 19.1, CI = 1.7 - 217.0, p = 0.017) were more likely to have TBI compared to those with other skull and facial fractures. Conclusion: fractures of parietal and frontal bones are associated with a higher risk of TBI in the KSA. Patients with TBI following road accidents with fractures of the frontal or parietal bones, particularly those in the 31-40 age group should therefore be treated with strong suspicion of underlying traumatic brain injury.