Defining Transfer Criteria for Isolated Facial Injuries
Francisco Castillo Diaz et al.
Journal of Trauma and Acute Care Surgery, May 9, 2025
[DOI: 10.1097/TA.0000000000004651]
🩺 Clinical Takeaways for the ED:
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Over half of isolated facial trauma transfers may be avoidable.
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Many of these patients can be managed without urgent intervention or hospital admission.
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Authors propose Facial Injury Guidelines to guide:
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When to consult facial trauma specialists
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When to transfer vs treat locally with outpatient follow-up
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Prospective validation is needed, but EDs may soon adopt criteria to reduce unnecessary transfers.
🧪 Methods:
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5-year retrospective review (2017–2021) at a Level I trauma center.
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Included: 511 transferred patients with isolated facial fractures.
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Transfers categorized as:
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Appropriate: Required emergency (immediate OR), urgent (same admission) intervention, or hospital admission.
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Potentially Inappropriate: No intervention or admission required.
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Three facial trauma experts independently validated the transfer appropriateness.
📊 Key Findings:
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259 patients (51%) were potentially unnecessary transfers.
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Among all 511:
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89% received FTS consult
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81% of potentially inappropriate transfers were discharged from ED (median LOS: 6 hrs)
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Appropriate transfers:
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54% admitted
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15% required emergency intervention
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79% underwent urgent procedures
Diaz, F.C., Anand, T., Khurshid, M.H., Kunac, A., Al Ma'ani, M., Colosimo, C., Hejazi, O., Ditillo, M., Magnotti, L.J. and Joseph, B., 2023. Look me in the face and tell me that I needed to be transferred: Defining the criteria for transferring patients with isolated facial injuries. Journal of Trauma and Acute Care Surgery, pp.10-1097.