Lesões maxilofaciais em crianças e adolescentes vítimas de causas externas atendidas em um serviço de referência: Um estudo retrospectivo

Abstract

Introduction: Morbidities due to external causes are frequent among children and adolescents and the consequences of these events may be responsible for temporary or permanent limitations, it is important to know their etiology for planning preventive actions. Objective: To characterize the demographic profile of children and adolescents hospitalized for external causes treated at a referral hospital and its association with the presence of maxillofacial injuries. Method: A retrospective, documentary, census-type study, which evaluated medical records of victims aged 0 to 19 years hospitalized for external causes in the years 2016 and 2017. Two trained researchers collected information regarding sex, age, office hours, etiology of hospitalization, regions of the body affected by trauma and characteristics of maxillofacial injuries. The data were analyzed using bivariate analysis, using the chi-square and Fisher's exact tests, and multivariate analysis, with Poisson regression with a robust estimator, adopting a significance level of 5%. At the end of the research stages, the writing of the work was organized in order to provide the construction of two scientific products, presented in the form of articles, with the general presentation of information on external causes and specifically on transport accidents and their associations with maxillofacial injuries. Results: In the first article, it was observed that facial injuries corresponded to 15.3% of cases, with 56.7% of the occurrences showing maxillofacial fractures, with the middle third of the face being more affected (38.2%). The adjusted multivariate analysis showed an association with the weekend (PR = 0.368, CI 95 = 0.152-0.891), with a 4-fold higher prevalence of maxillofacial injury in the occurrence of violence (PR = 4.224, CI 95 = 1.935-9.219). It was also identified that 75% of hospitalizations were male, mostly adolescents (66.5%), affected at night (41.2%). Transport accidents were the most common cause (62.6%) among adolescents, while for children, falls predominated (49%). The upper limbs region was the most affected (41.7%). For the second article, maxillofacial injuries were present in 16.2% of victims of transport accidents, with 75.3 of maxillofacial fractures, with the mandible as the most affected bone. It was observed that the involvement of motorcycles was the most prevalent (68.3%), with adolescents being the most affected (81.3%), differently from what happened with children, who were more involved in pedestrian accidents. Increasing age revealed an increase in the prevalence of the outcome, with a significant association in the final multivariate analysis (p <0.001). Weekend increases the prevalence of occurrence of transport accidents. Conclusion: Maxillofacial injuries were associated with the weekend, in addition to four times the prevalence of this outcome among victims of violence, with the mandible being the bone most affected in maxillofacial fractures in cases of transport accident. External causes were more prevalent among males, adolescents, with a predominant cause of hospitalization due to transport accidents, with the upper limbs region being the most affected. Transport accidents involving motorcycles were more frequent, with the lower limbs the most affected in this outcome.