{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:17:48Z","timestamp":1779193068256,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Craniomaxillofacial (CMF) trauma represents a significant proportion of global surgical disease burden, disproportionally affecting low\u2010 and middle\u2010income countries where care is often delayed. We investigated risk factors for delays to care for patients with CMF trauma presenting to the highest\u2010volume trauma hospital in Rwanda and the impact on complication rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>This prospective cohort study comprised all patients with CMF trauma presenting to the University Teaching Hospital of Kigali, Rwanda, between June 1 and October 1, 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Urban referral center in resource\u2010limited setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Epidemiologic data were collected, and logistic regression analysis was undertaken to explore risk factors for delays in care and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010four patients (94.4% men) met criteria for inclusion. The mean age was 30 years. A majority of patients presented from a rural setting (n = 34, 63%); the most common cause of trauma was motor vehicle accident (n = 18, 33%); and the most common injury was mandibular fracture (n = 28, 35%). An overall 78% of patients had delayed treatment of the fracture after arrival to the hospital, and 81% of these patients experienced a complication (n = 34, <jats:italic>P<\/jats:italic> =. 03). Delay in treatment was associated with 4\u2010times greater likelihood of complication (odds ratio, 4.25 [95% CI, 1.08\u201016.70]; <jats:italic>P<\/jats:italic> =. 038).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Delay in treatment of CMF traumatic injuries correlates with higher rates of complications. Delays most commonly resulted from a lack of surgeon and\/or operating room availability or were related to transfers from rural districts. Expansion of the CMF trauma surgical workforce, increased operative capacity, and coordinated transfer care efforts may improve trauma care.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2473974x221096032","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T07:22:24Z","timestamp":1650612144000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Effect of Delay of Care for Patients with Craniomaxillofacial Trauma in Rwanda"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2247-8000","authenticated-orcid":false,"given":"Gaelen B.","family":"Stanford\u2010Moore","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013San Francisco San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilbert","family":"Niyigaba","sequence":"additional","affiliation":[{"name":"Department of ENT College of Medicine and Health Sciences University of Rwanda Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gratien","family":"Tuyishimire","sequence":"additional","affiliation":[{"name":"Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Yau","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye &amp; Ear Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amol","family":"Kulkrani","sequence":"additional","affiliation":[{"name":"Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Nyabyenda","sequence":"additional","affiliation":[{"name":"Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaie","family":"Ncogoza","sequence":"additional","affiliation":[{"name":"Department of ENT College of Medicine and Health Sciences University of Rwanda Kigali Rwanda"},{"name":"Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Shaye","sequence":"additional","affiliation":[{"name":"Department of Surgery University Teaching Hospital of Kigali Kigali Rwanda"},{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye &amp; Ear Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Word Health Organization.Injuries and violence: the facts. 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