Effect of COVID-19 Italian Lockdown on Maxillofacial Trauma Related to Domestic Violence: A Retrospective Cohort Study

Abstract

Background: This retrospective study aims to identify the potential reasons for the increase in maxillofacial trauma from domestic violence in the first COVID-19 lockdown and propose some strategies that could be effective in fighting it during any future pandemic events. Materials and Methods: The study was conducted on patients with maxillofacial trauma who arrived at the Maxillofacial Unit of the Magna Graecia University of Catanzaro from 9 March to 3 May 2020, who were compared with those registered in the same period in 2019. Inclusion criteria were: patients of both sexes and admission diagnosed with maxillofacial trauma with or without bone fracture. Exclusion criteria were: patients less than 7 years of age, maxillofacial trauma that occurred outside the established period, and patients unconscious or with unclear clinical history. Patients were divided into two groups according to the mechanism of injury (MOI): “domestic” and “non-domestic” trauma. Both descriptive and regressive statistical analysis was conducted using a Student’s t-test with a significance level set at p < 0.05. Results: The total number of maxillofacial fractures in 2020 was similar to 2019 (31 pcs in 2020 vs. 38 pcs in 2019). Before the lockdown, most of the trauma occurred in non-domestic settings (25% in 2020 vs. 76.67% in 2019), especially in road accidents (4.17% in 2020 vs. 20% in 2019). During the lockdown, most of the trauma occurred in a domestic setting (75% in 2020 vs. 23.33% in 2019), especially interpersonal violence (31.58% in 2020 vs. 14.28% in 2019). There were 7 cases of interpersonal violence recorded in 2020 (1 male and 6 female), compared to only one case (female) recorded in 2019, with a statistically significant p-Value (0.0475). Conclusions: The first COVID-19 lockdown has provided the opportunity to study the aetiology of domestic trauma due to interpersonal violence attributable to economic and social problems, all of which were aggravated by the impediment to requesting help due to the difficulty of contacting the services and the general slowdown in the ways out of violence. The analysis conducted and compared with data in the literature suggests the adoption of a proactive (and non-reactive) approach to combat domestic violence during pandemic events.

Orbital Fractures Treated in a University Hospital of Southern Italy: Epidemiology, Outcomes and Prognostic Factors Resulting From 538 Retrospectively Analyzed Cases.

“…However, in 2019-2020 there was a reversal of the etiological trend with 31.8% of trauma due to aggression compared to 6% recorded in previous years. During the 2020 lockdown, most traumas occurred in a domestic environment (75% in 2020 vs. 23.33% in 2019), particularly interpersonal violence in women (31.58% in 2020 vs. 14.28% in 2019) [17]. This reversal of the etiological trend was also highlighted in the Campania and Umbria regions [18][19].…”

Dynamic Trends in Surgical Oromaxillofacial Trauma Epidemiology: A Comparative Study of Pre-COVID-19 and COVID-19 Periods in Tertiary Referral Hospitals in Madrid

“…A possible effect during the most severe moments of the pandemic was the lower willingness to seek medical attention in subacute maxillofacial processes (such as precancerous lesions, cancer, or infections) and the prognostic implication that this implied [30,37]. The availability of adequate protective material and understanding the route of contagion of COVID-19 have made it possible to treat fractures in a similar way in the pandemic and prepandemic periods, with various limitations by country in the most severe peaks of the pandemic [38][39][40][41][42]. In the postpandemic period, various studies have found that health professionals reduced their protective measures [38] due to burnout or psychological reasons, among others.…”