A comparison of maxillofacial trauma before and after implementation of lockout laws in Sydney

Background: Lockout reforms were introduced in February 2014 by the New South Wales government in an attempt to curb alcohol-related violence in Sydney, following a number of fatalities. Changes include 1.30 a.m. venue lockouts and the 3 a.m. cessation of alcohol service. This study aims to assess the results of these reforms through analysis of departmental treatment data. All maxillofacial fractures that required operative management at St Vincent’s Hospital, Sydney, over a two-year period pre and post reforms were analysed. Methods: Medical information, from multiple sources, of patients that required operative management for maxillofacial fractures over a 2-year period (2012-2014) were compared to those between (2014-2016). Data collected included age, gender, demographics, mechanism of injury, pattern of injury, treatment required, association with alcohol, time and place of injury, and long-term complications. Results: 145 maxillofacial fractures were operatively treated prior to the reforms compared to only 58 (p<0.001) post. Reported incidents occurring in the city significantly fell from 54 to 15 (p<0.001), with no change in peripheral locations. The operated cases associated with alcohol dropped post reforms (102/145 (70%) vs 33/58 (57%). The number of assaults related to ‘king hits’ significantly reduced from 30 (33%) to just 5 (19.2%). Conclusion: This study demonstrates a clear correlation with the reduction in maxillofacial trauma, alcohol and violence in a localised region of Sydney since the arrival of the lockout reforms. As such, it can provide guidance to other regions in Australia into the effects of such laws and its repercussions on patient care and service.