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Bezzini D, Lanari M, Amaddeo A, Aricò MO, Castagno E, Cherchi G, Giacomini G, Graziani G, Grosso S, Liguoro I, Lombardi F, Manieri S, Moschettini L, Parisi F, Reale A, Romanisio G, Silvagni D, Schiavetti I. Frequency and type of domestic injuries among children during COVID-19 lockdown: what changes from the past? An Italian multicentre cohort study. Eur J Pediatr 2023; 182:3445-3454. [PMID: 37184645 PMCID: PMC10183681 DOI: 10.1007/s00431-023-04990-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023]
Abstract
Accidents are the main cause of injury in children, more than half events happen at home. Aims of this study were to assess if SARS-CoV-2 lockdown influence emergency department (ED) visits due to children domestic accident (DAs) and to identify factors associated with hospitalization. This was a multicentre, observational, and retrospective cohort study involving 16 EDs in Italy and enrolling children (3-13 years) receiving a visit in ED during March-June 2019 and March-June 2020. Risk factors for hospitalization were identified by logistic regression models. In total, 8860 ED visits due to domestic accidents in children occurred before (4380) and during (4480) lockdown, with a mean incidence of DA of 5.6% in 2019 and 17.9% in 2020 (p < 0.001) (IRR: 3.16; p < 0.001). The risk of hospitalization was influenced by the type of occurred accident, with fourfold higher for poisoning and twofold lower risk for stab-wound ones. In addition, a higher risk was reported for lockdown period vs 2019 (OR: 1.9; p < 0.001), males (OR: 1.4; p < 0.001), and it increased with age (OR: 1.1; p < 0.001). Conclusions: The main limitation of this study is the retrospective collection of data, available only for patients who presented at the hospital. This does highlight possible differences in the total number of incidents that truly occurred. In any case, the COVID-19 lockdown had a high impact on the frequency of DAs and on hospitalization. A public health campaign aimed at caregivers would be necessary to minimize possible risks at home. What is Known: • In Italy, domestic accidents are the second leading cause of paediatric mortality after cancer. • During the first SARS-CoV-2 lockdown in 2020, a sharp decrease in the total number of Emergency Departments visits for all causes was observed, both in children and in adults. What is New: • During the first SARS-CoV-2 lockdown in 2020, domestic accidents involving children increased threefold from the previous year. • Higher risk of hospitalization was showed in minors accessing during 2020 vs 2019, in males than in females and it increased with advancing age. Considering the type of injury, a significant higher risk of hospitalization for poisoning was observed.
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Affiliation(s)
- Daiana Bezzini
- Department of Life Sciences, University of Siena, via Aldo Moro 2, 53100, Siena, Italy.
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Melodie O Aricò
- Pediatric Department, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy
| | - Emanuele Castagno
- Department of Paediatric Emergency, Regina Margherita Children's Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Giulia Graziani
- Department of Paediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Salvatore Grosso
- Clinical Paediatrics, Department of Molecular Medicine and Development, University of Siena, Siena, Italy
| | - Ilaria Liguoro
- Division of Paediatrics, Department of Medicine (DAME), University of Udine, Udine, Italy
- Pediatric Clinic, "Santa Maria della Misericordia" University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Francesca Lombardi
- Pediatric Department, Maggiore Hospital Carlo Alberto Pizzardi, Bologna AUSL, Bologna, Italy
| | - Sergio Manieri
- Department of Paediatrics, San Carlo Hospital, Potenza, Italy
| | | | - Francesca Parisi
- Department of Medicine and Surgery, Pediatric Clinic, University of Perugia, Perugia, Italy
| | - Antonino Reale
- Department of Emergency and General Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giulia Romanisio
- Pediatric and Neonatology Unit, ASL 2 Ospedale San Paolo, Savona, Italy
| | - Davide Silvagni
- Department of Paediatric Emergency, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Irene Schiavetti
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Is a Parry Fracture-An Isolated Fracture of the Ulnar Shaft-Associated with the Probability of Abuse in Children between 2 and 16 Years Old? CHILDREN-BASEL 2021; 8:children8080650. [PMID: 34438541 PMCID: PMC8394848 DOI: 10.3390/children8080650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/16/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
A parry fracture is an isolated fracture of the ulnar shaft. It occurs when the ulna receives the full force of an impact when the forearm is raised to protect the face. The aim of this study is to assess a possible association between a parry fracture and the probability of abuse in children. In this retrospective, observational, multicenter study, we identified patients between 2 and 16 years old who had been treated for an isolated ulnar shaft fracture. Patient characteristics were registered, anonymized radiographs were rated, and charts were screened for referral to a child protective team. A total of 36 patients were analyzed. As no referrals were registered during follow-up, the primary outcome was changed to a perpendicular force as trauma mechanism. Univariable regression analysis and independent t-test both showed no significant association between patient factors or radiographic classification, and the reported trauma mechanism. We were unable to determine an association between a parry fracture and the probability of abuse. Since trauma mechanism does have a biomechanical effect on the fracture type, we would advise that a very clear reconstruction (and documentation) of the trauma mechanism should be established when a parry fracture is identified on radiographs.
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