Academic Unit of Paediatric Radiology, Royal Manchester Children's Hospital, Manchester, UK
Division of Informatics, Imaging, and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, UK.
Arch Dis Child. 2022 Jun;107(6):575-581. doi: 10.1136/archdischild-2021-323444. Epub 2022 Feb 17.
Rate and severity of radiological features of physical abuse in children during the first UK-wide COVID-19 enforced national lockdown.
To assess the number, type and outcome of radiological investigations for children presenting to hospital with suspected physical abuse (SPA; including abusive head trauma) during the first national COVID-19 enforced lockdown compared with the prelockdown period.
Multicentre, retrospective, observational, interrupted time series analysis.
Eight secondary/tertiary paediatric centres between January 2018 and July 2020 inclusive.
1587 hospital assessed children undergoing radiographic skeletal surveys (SkS) and head CT imaging performed for SPA/child protection concerns.
Incidence and severity of fractures identified on SkS; head injury (composed of incidence rates and ratios of skull fracture, intracranial haemorrhage (ICH) and hypoxic ischaemic injury (HII)) on head CT imaging; and ratio of antemortem and postmortem SkS.
1587 SkS were performed: 1282 (81%) antemortem, 762 (48%) male, and positive findings in 582 (37%). Median patient age was 6 months. There were 1.7 fractures/child prelockdown versus 1.1 fractures/child during lockdown. There was no difference between positive/negative SkS rates, the absolute ratio of antemortem/postmortem SkS or absolute numbers of head injury occurring between January 2018 and February 2020 and the lockdown period April-July 2020. Likewise, prelockdown incidence and rates of skull fracture 30/244 (12%), ICH 28/220 (13%) and HIE 10/205 (5%) were similar to lockdown, 142/1304 (11%), 171/1152 (15%) and 68/1089 (6%), respectively.
The first UK COVID-19 lockdown did not lead to an increase in either the number of antemortem or postmortem radiological investigations performed for SPA, or the number or severity of fractures and intracranial injuries identified by these investigations.
在英国首次全国性 COVID-19 强制封锁期间，儿童身体虐待的放射学特征的发生率和严重程度。
评估在第一次全国性 COVID-19 强制封锁期间，因疑似身体虐待（包括虐待性头部创伤）而到医院就诊的儿童进行放射学检查的数量、类型和结果，与封锁前时期相比。
多中心、回顾性、观察性、中断时间序列分析。
2018 年 1 月至 2020 年 7 月期间的 8 个二级/三级儿科中心。
1587 名接受过放射学骨骼检查（SkS）和头部 CT 成像检查的接受 SPA/儿童保护检查的住院评估儿童。
SkS 上发现的骨折发生率和严重程度；头部 CT 成像上的头部损伤（由颅骨骨折、颅内出血 (ICH) 和缺氧缺血性损伤 (HII) 的发生率和比率组成）；以及生前和死后 SkS 的比率。
进行了 1587 次 SkS：1282 次（81%）生前，762 次（48%）为男性，582 次（37%）阳性。中位患者年龄为 6 个月。封锁前每例儿童有 1.7 处骨折，封锁期间每例儿童有 1.1 处骨折。阳性/阴性 SkS 率、生前/死后 SkS 的绝对比值或 2018 年 1 月至 2 月和封锁期间（2020 年 4 月至 7 月）头部损伤的绝对数量之间无差异。同样，封锁前颅骨骨折的发生率和发生率为 30/244（12%）、ICH 为 28/220（13%）和 HIE 为 10/205（5%），与封锁期间的 142/1304（11%）、171/1152（15%）和 68/1089（6%）相似。
英国首次 COVID-19 封锁并没有导致 SPA 进行的生前或死后放射学检查数量增加，也没有导致这些检查发现的骨折和颅内损伤的数量或严重程度增加。
