{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:45:24Z","timestamp":1760147124588,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Trauma is the leading cause of morbidity and mortality in the pediatric population. During the COVID-19 pandemic (COVID-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 COVID-19, focusing on trauma mechanisms, violence-related trauma (VRT) and intentionality, especially suicide attempts (SAs). 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 analyses. Results: There were 684 cases of PT accepted at NTC: 84 in 2015, 98 in 2016, 125 in 2017, 119 in 2018, 114 in 2019 and 144 in 2020 (p &lt; 0.001), 66.2% male, mean age 9.88 (\u00b15.17). We observed a higher number of traffic-related, fall-related injuries and an increasing trend for VRT and SAs, peaking in 2020. We report an increasing trend over time for head trauma (p = 0.002). The Injury Severity Score did not significantly change. During COVID-19 we recorded a higher number of self-presenting patients with low priority codes. Conclusions: NTC is the adult level I referral trauma center for the Milan urban area with pediatric commitment. During COVID-19, every traumatic emergency was centralized to NCT. In 2020, we observed an increasing trend in SAs and VRT among PT patients. The psychological impact of the COVID-19 restriction could explain this evidence. The long-term effects of COVID-19 on the mental health of the pediatric population should not be underestimated. Focused interventions on psychological support and prevention of SAs and VRT should be implemented, especially during socio-demographic storms such as the last pandemic.<\/jats:p>","DOI":"10.3390\/jpm13010128","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T05:57:14Z","timestamp":1673243834000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Increasing Trend in Violence-Related Trauma and Suicide Attempts among Pediatric Trauma Patients: A 6-Year Analysis of Trauma Mechanisms and the Effects of the COVID-19 Pandemic"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8754-1007","authenticated-orcid":false,"given":"Cecilia","family":"Maina","sequence":"first","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"General Surgery, I.R.C.C.S. San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5453-8901","authenticated-orcid":false,"given":"Stefano","family":"Cioffi","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Altomare","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Spota","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5843-4114","authenticated-orcid":false,"given":"Francesco","family":"Virdis","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4512-6243","authenticated-orcid":false,"given":"Roberto","family":"Bini","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Ragozzino","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Renzi","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4286-8866","authenticated-orcid":false,"given":"Elisa","family":"Reitano","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Translational Medicine, Maggiore Della Carit\u00e0 Hospital, University of Eastern Piedmont, Corso Giuseppe Mazzini 18, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Corasaniti","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Macchini","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2409-2109","authenticated-orcid":false,"given":"Osvaldo","family":"Chiara","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7874-2640","authenticated-orcid":false,"given":"Stefania","family":"Cimbanassi","sequence":"additional","affiliation":[{"name":"Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation-State University of Milan-Acute Care Surgery and Trauma, ASST-GOM Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2468","DOI":"10.1056\/NEJMsr1804754","article-title":"The Major Causes of Death in Children and Adolescents in the United States","volume":"379","author":"Cunningham","year":"2018","journal-title":"N. 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