Department of Emergency and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Clinical Pathways and Epidemiology Unit-Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Ital J Pediatr. 2022 Jul 27;48(1):129. doi: 10.1186/s13052-022-01318-2.
We proposed to analyze thoroughly the impact of the COVID-19 lockdown (CL) in changes of profiles and in trend of the domestic accidents (DAs) in children.
This was a single experience, cross-sectional study conducted at the emergency department (ED) of III trauma center. We enrolled children under 18 years admitted to ED with a diagnosis of DAs comparing the CL period from 10 March 2020 to 4 May 2020 with the same period of the previous year,10 March 2019 to 4 May 2019.
In CL period, the cumulative incidence of ED visits for DAs increased from 86.88 to 272.13 per 1,000 children and the cumulative incidence of hospitalizations for DAs increased from 409.72 to 534.48 per 1,000 children. We reported in CL a decrease in the severity of ED presentation assessed by proxy measures: the level of priority ED visits reduced by 67% in CL period (OR: 0.33; 95%CI 0.22-0.48; p < 0.001); the likelihood of delayed time of presentation to ED increased by 65% in case of domestic injuries occurring in CL period (OR: 1.65; 95% CI: 1.17-2.34; p = 0.004); the odds of transfer from other hospital decreased by 78% in CL (OR: 0.15-0.33; p < 0.001). Children were more at risk of poisoning (OR:3.35-106.11; p = 0.001), of body foreign ingestion (OR: 1.83-14.39; p = 0.002) and less at risk of animal bite trauma (OR:0.05-0.35; p < 0.001).
Although the need to stay home has made a decisive breakthrough on the spread of COVID-19, the experience from this study underlines how this preventive measure has also had a downside in term of increased cumulative incidence of ED visits and of hospitalizations for DA.
我们拟分析 COVID-19 封锁(CL)对儿童意外伤害(DA)的特征变化和趋势的影响。
这是一项在三级创伤中心急诊部进行的单中心、横断面研究。我们纳入了 2020 年 3 月 10 日至 5 月 4 日 CL 期间与 2019 年同期(3 月 10 日至 5 月 4 日)诊断为 DA 而收入急诊部的 18 岁以下儿童,比较 CL 期和非 CL 期。
CL 期间,急诊就诊 DA 的累积发病率从 86.88 增至 272.13/1000 儿童,住院 DA 的累积发病率从 409.72 增至 534.48/1000 儿童。CL 期间,通过替代指标报告的急诊就诊严重程度降低:CL 期优先急诊就诊的比例降低 67%(OR:0.33;95%CI 0.22-0.48;p<0.001);CL 期发生的家庭创伤延迟就诊的可能性增加 65%(OR:1.65;95%CI:1.17-2.34;p=0.004);CL 期从其他医院转来的可能性降低 78%(OR:0.15-0.33;p<0.001)。儿童更易发生中毒(OR:3.35-106.11;p=0.001)、体腔内异物摄入(OR:1.83-14.39;p=0.002),而动物咬伤创伤的风险降低(OR:0.05-0.35;p<0.001)。
尽管居家隔离对 COVID-19 的传播起到了决定性的作用,但本研究提示这种预防措施也带来了负面影响,即导致急诊就诊和住院治疗 DA 的累积发病率增加。