Increasing trend of violence-related trauma and suicide attempts among pediatric trauma patients: A 6 years analysis of trauma mechanisms and the effects of the Covid-19 pandemic

Abstract text (incl. references and figure legends)

Background: Trauma is the leading cause of morbidity and mortality in the pediatric population. During the Covid-19 pandemic (C-19), different trends for Pediatric Trauma (PT) were described. This study aims to explore the trend over time of PT in our center, also considering the effects of C-19, focusing on trauma mechanisms, violence-related trauma (VRT), and intentionality, especially suicide attempts (SA). Methods: All PT patients accepted at Niguarda Trauma Center (NTC) in Milan from January 2015 to December 2020 were retrospectively analyzed. We considered demographics and clinical variables and performed descriptive and year comparison analysis Results: 684 PT were accepted at NTC: 84 in 2015, 98 in 2016, 125 in 2017, 119 in 2018, 114 in 2019, and 144 in 2020 (p<0.001); 66.2% male, mean age 9.88 (± 5.17). We observed more traffic-related, fall-related injuries and an increasing trend for VRT and SA, peaking in 2020. VRT and SA were higher among PT > 12 years old. We report an increasing trend over time for head trauma (p=0.002). The Injury Severity Score did not significantly change. During C-19 we recorded a higher number of self-presenting patients with low priority codes. Conclusions: We herein report a higher number of traffic-related and fall-related PT over time. The increasing number of road and fall-related PT is in line with published reports. In 2020 we observed a peak of SA and VRT among PTs. The psychological impact of the C-19 restriction could explain this evidence. We highlighted an alarming trend among PT due to societal changes and the C-19. The long-term effects of C-19 on the mental health of the pediatric population should not be underestimated. Early focused educational and psychological interventions should be implemented among the pediatric population to prevent road-related trauma, SA and VRT. Surgical societies should cooperate with pediatric ones to build common strategies for prevention.References: Sanford et al.J.Pediatr.Surg.2021

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