Psychologic functioning and needs of indigent patients with facial injury: A prospective controlled study

Purpose: This study sought to examine 1) temporal changes in psychologic functioning over 12 months and 2) baseline differences in mental health and social service needs between orofacial injury patients and sociodemographically comparable controls undergoing elective oral surgery. Materials and Methods: Prospective, case-control study of patients treated at a public hospital in Los Angeles, CA. A total of 336 subjects with mandible fractures and 119 subjects undergoing elective removal of their third molars participated in structured, repeated follow-up assessments (10 days, 6 months, and 12 months after their surgical procedures). Multiple imputation was used to manage incomplete data, and propensity score analysis was used to correct for covariate imbalances between the injury and the control cohort. A series of ANOVAs, chi(2) analyses, and odds ratios was conducted. Results: The injury patients continue to experience significant psychologic distress for tip to 12 months following the traumatic event. Orofacial injury patients also tend to report more lifetime and current mental health and social service needs than the sociodemographically similar elective-surgery cohort. Conclusion: The management of facial injuries in disadvantaged individuals should integrate case management that addresses psychosocial sequelae and service needs of patients. (C) 2004 American Association of Oral and Maxillofacial Surgeons.