scholarly journals P097: Evaluation of an oral morphine protocol for treatment of acute pain crisis in sickle cell patients in the outpatient setting

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S110-S111
Author(s):  
H. Paquin ◽  
E.D. Trottier ◽  
Y. Pastore ◽  
N. Robitaille ◽  
M. Dore Bergeron ◽  
...  
Keyword(s):  
Oral Administration ◽  
Sickle Cell ◽  
Oral Morphine ◽  
Retrospective Chart Review ◽  
Outpatient Setting ◽  
Hospitalization Rate ◽  
Hospitalization Rates ◽  
Significant Difference ◽  
Administration Time ◽  
Opiate Administration

Introduction: Sickle cell vaso-occlusive crisis (VOC) is one of the most frequent causes of emergency visit and admission in children with this condition. With this study, we aim to evaluate whether the implementation of an oral morphine protocol has led to improved care of sickle cell disease (SCD), translated by a reduced hospitalization rate, an increased oral administration rate and faster opiate administration time, comparing cohorts of patients presenting to the emergency department (ED) and hematology outpatient clinic (HOC) with VOC pre and post implementation. Methods: Retrospective chart review of patients with SCD followed at CHU Ste-Justine, who presented to the ED and HOC with VOC, in the year pre and post implementation of the protocol. Patients with a VOC diagnosis during the study periods were selected in each department’s database. The primary outcome was to evaluate the hospitalization rate. The rate of oral administration, as well as the opiate administration time from inscription in the ED or arrival in the HOC were also calculated. We estimated that 35 patients per arm would be sufficiently powered to detect at least a 30% rate reduction of admissions, with a power of 80% and a significance of 0.05. Results: Over the two periods, a total of 105 patients (49 pre and 56 post) were included from the ED and 62 patients (36 pre and 26 post) from the HOC. Both departments showed a reduction in hospitalization rate: a difference of 48% (95% CI 32, 61) in ED and 38% (95% CI 13, 57) in HOC. Both showed an increase in the rate of oral administration: a difference of 36% (95% CI 19, 50) in ED and 33% (95% CI 8, 53) in HOC. There was a non-significant difference of 10 min (95% CI -10, 25) in the opiate administration time in ED, as opposed to HOC where a significant difference of -45 min (95% CI -71, -6) was found, with both presenting median times over the recommended 60 minutes post implementation. Both settings showed an increase in the percentage of patients without IVs; a difference of 17% (95% CI 4, 30) in ED and 55% (95% CI 72, 31) in HOC. Conclusion: This study validates the use of our oral morphine protocol for the treatment of VOC, by showing a significant reduction in hospitalization rates. Although delays remain in our opiate administration time, our protocol decreased the number of painful IV procedures.

scholarly journals Evaluation of a clinical protocol using intranasal fentanyl for treatment of vaso-occlusive crisis in sickle cell patients in the emergency department

2019 ◽  
Vol 25 (5) ◽  
pp. 293-299
Author(s):  
Hugo Paquin ◽  
Evelyne D Trottier ◽  
Yves Pastore ◽  
Nancy Robitaille ◽  
Marie-Joelle Dore Bergeron ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sickle Cell ◽  
Chart Review ◽  
Primary Outcome ◽  
Retrospective Chart Review ◽  
Hospitalization Rates ◽  
Number Of Patients ◽  
Implementation Period ◽  
Administration Time ◽  
Opiate Administration

Abstract Background Vaso-occlusive crisis (VOC) is one of the most frequent causes of emergency visits and admission in children with sickle cell disease (SCD). Objectives This study aims to evaluate whether the use of a new pain management pathway using intranasal (IN) fentanyl from triage leads to improved care, translated by a decrease in time to first opiate dose. Methods We performed a retrospective chart review of patients with SCD who presented to the emergency department (ED) with VOC, in the period pre- (52 patients) and post- (44 patients) implementation period of the protocol. Time to first opiate was the primary outcome and was evaluated pre- and postimplementation. Patients received a first opiate dose within 52.3 minutes of registration (interquantile range [IQR] 30.6, 74.6), corresponding to a 41.4-minute reduction in the opiate administration time (95% confidence interval [CI] −56.1, −27.9). There was also a 43% increase in the number of patients treated with a nonintravenous (IV) opiate as first opiate dose (95% CI 26, 57). In patients who were discharged from the ED, there was a 49% decrease in the number of IV line insertions (95% CI −67, −22). There was no difference in the hospitalization rates (difference of 6 [95% CI −13, 25]). Conclusions This study validates the use of our protocol using IN fentanyl as first treatment of VOC in the ED by significantly reducing the time to first opiate dose and the number of IVs.

scholarly journals 1692. Retrospective Review on the Safety and Efficacy of Nitrofurantoin for the Treatment of Cystitis in the Veteran Population With or Without Renal Insufficiency

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S829-S830
Author(s):  
Elwyn W Welch ◽  
Shaila Sheth ◽  
Chester Ashong ◽  
Caroline Pham
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Clinical Cure ◽  
Clinical Cure Rate ◽  
Retrospective Chart Review ◽  
Outpatient Setting ◽  
Secondary Outcome ◽  
Cure Rate ◽  
Acute Cystitis ◽  
Significant Difference

Abstract Background Nitrofurantoin has been used to treat cystitis in women; however, data supporting its use in men is lacking. In addition, recent retrospective studies have challenged the manufacturer’s recommendation to avoid nitrofurantoin with creatinine clearances (CrCl) less than 60 mL/min. The purpose of this study is to compare the efficacy and safety of nitrofurantoin for the treatment of acute cystitis in male and female veterans with variable degrees of renal dysfunction. Methods A retrospective chart review was conducted in adult patients who received nitrofurantoin for acute cystitis in the outpatient setting between May 1, 2018 and May 1, 2019. The primary outcomes were rates of clinical cure as compared between males and females, and across various renal function groups (CrCl greater than 60 mL/min, 30 to 60 mL/min, and less than 30 mL/min) following treatment with nitrofurantoin. The secondary outcome was adverse event rates. Results A total of 446 patients were included with 278 females and 168 males. Overall clinical cure rate was 86.5% (n=386). Clinical cure rate did not vary between genders (p=0.0851) or CrCl ranges (p=1.0) as shown in the tables. Benign prostatic hyperplasia (BPH) was associated with decreased odds of clinical cure (OR 0.50 [95% CI 0.26-0.97], p=0.0404) in addition to cirrhosis (OR 0.22 [95% CI 0.06-0.91], p=0.0357). Adverse events occurred in 2% of patients and did not vary based on gender or renal function. RATES OF CLINICAL CURE Conclusion There was no statistically significant difference in clinical cure with nitrofurantoin between genders and various renal impairments. However, history of BPH and cirrhosis were associated with decreased efficacy. Subgroup analysis also revealed lower efficacy in males with CrCl greater than 60 mL/min versus females with similar renal function. This study adds to the growing body of literature suggesting that renal dysfunction with CrCl of 30 to 60 mL/min may not carry the risk of treatment failure and adverse effects previously associated with nitrofurantoin, but large randomized trials are needed to confirm these results. Disclosures All Authors: No reported disclosures

610 Small Pediatric Burns Can Be Safely Managed on an Outpatient Basis

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S148-S149
Author(s):  
Andrea C Grote ◽  
Alexandra M Lacey ◽  
Warren L Garner ◽  
Justin Gillenwater ◽  
Ellen Maniago ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Outpatient Setting ◽  
Outpatient Basis ◽  
Close Monitoring ◽  
Burn Center ◽  
Increased Risk ◽  
Significant Difference ◽  
Pediatric Burns ◽  
Inpatient Management

Abstract Introduction American Burn Association guidelines recommend that all pediatric burns be transferred to a burn center if their presenting hospital lacks the necessary personnel or equipment for their care. Our institution often treats small (< 10% TBSA) burns in pediatric patients as outpatients with a non-daily dressing. The aim of this study was to determine if small pediatric burns could be managed in an outpatient manner and risk factors for failure. Methods A retrospective chart review was conducted from July 2016 to July 2019 at a single ABA-verified burn center. All patients under the age of 18 who presented for evaluation were included. Post burn day, age, sex, TBSA, burn etiology, body area burned, burn dressing type, outpatient versus inpatient management, reason(s) for admission, and any operative intervention were collected. Results In total, 742 patients were included in our cohort (Table 1). The most common burn etiologies were scald (68%), contact (20%), and flame (5%). From initial presentation, 101 patients (14%), mean TBSA 9%, were admitted to the burn unit and 641 patients (86%), mean TBSA 3%, were treated outpatient. Of those, 613 (96%) were treated entirely outpatient and 28 (4%) were admitted at a later date. There were no significant differences in age (p=0.6) nor gender distribution between those who were successfully treated outpatient and those who failed. There was a significant difference (p < 0.001) in TBSA between the patients who were treated successfully as outpatients (3±2%) versus those who failed outpatient care (4±3%). The primary reason for admission of these patients was nutrition optimization (61%). Conclusions The vast majority of small pediatric burns can be treated as an outpatient with a non-daily dressing with good results. Over 80% of pediatric patients seen in our clinic were successfully managed in this manner. As suspected, when the burns are larger in size (>4% TBSA) there is a potential increased risk for admission especially with regards to poor PO intake, so this requires close monitoring and family education. Applicability of Research to Practice Pediatric patients with small burns can be safely managed in an outpatient setting with a non-daily dressing. Those who fail will most likely fail from poor PO intake at home.

scholarly journals Analysis of measles-related hospitalizations in Tuscany from 2000 to 2014

2016 ◽  
Vol 144 (12) ◽  
pp. 2605-2612 ◽  
Author(s):  
E. BERTI ◽  
S. SOLLAI ◽  
E. ORLANDINI ◽  
L. GALLI ◽  
M. DE MARTINO ◽  
...  
Keyword(s):  
Young Adults ◽  
Age Groups ◽  
Public Health Problem ◽  
Hospitalization Rate ◽  
Measles Elimination ◽  
Hospitalization Rates ◽  
Significant Difference ◽  
Measles Outbreaks ◽  
Measles Incidence ◽  
Discharge Database

SUMMARYTo evaluate measles incidence and its relevant changes over a 14-year period (2000–2014), we analysed data from the regional hospital discharge database on children and adults hospitalized in Tuscany, Italy. A total of 181 paediatric and 413 adult cases were identified. Despite all the efforts towards regional measles elimination, we observed that the overall measles hospitalization rates for children and adults living in Tuscany globally increased from 0·45 to 0·85/100 000 during the study period (P = 0·001) showing fluctuations due to periodic measles outbreaks. Data stratified by age group showed that the hospitalization rate significantly increased in young adults over the study period, confirming an increase in susceptibility to measles in this subpopulation. Conversely, no statistically significant difference was observed in the hospitalization rate in the other age groups. However, children aged <1 year still exhibit the highest hospitalization rate. Pneumonia represented the most common complication in both the adult and children subsets. No death was reported. Measles still represents a public health problem, and national strategies should be implemented, focusing on emergent susceptible subsets, such as infants and young adults.

scholarly journals Inpatient Utilization Among Children and Adolescents with Sickle Cell Disease: Analysis of a Large Populated-Based Retrospective Cohort

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3262-3262 ◽  
Author(s):  
Rodney Theodore ◽  
Vaughn Barry ◽  
Maa-Ohui Quarmyne ◽  
Carlton Dampier ◽  
Peter A. Lane
Keyword(s):  
Sickle Cell Disease ◽  
Children And Adolescents ◽  
Hospital Discharge ◽  
Sickle Cell ◽  
Hospitalization Rate ◽  
Hospital Utilization ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Readmission Rates ◽  
Hospitalization Rates

Abstract Background: Sickle cell disease (SCD) is characterized by marked heterogeneity in clinical outcomes, severity and utilization of health care services. This heterogeneity is particularly evident with regards to utilization of inpatient hospital services. Some children with SCD are frequently admitted to the hospital while others are rarely or never admitted. In addition, rates of readmission within 30 days of hospital discharge are high in SCD. The causes of this variable utilization and high rates of readmission are not well understood. Objectives: We sought to determine rates and primary causes of SCD-related hospital utilization among children and adolescents with SCD and to determine whether rates of hospitalization and of 7-, 14- and 30-day readmissions varied by age, SCD genotype, gender and cause of hospitalization. Methods: Children who lived in the 28-county greater metro Atlanta area with a confirmed SCD diagnosis and who received care at the ChildrenÕs Healthcare of Atlanta (CHOA) SCD program between January 1, 2010 through December 31, 2014 were included. The earliest and latest encounter during the five-year period was used to determine total length of observation for each patient. To ensure a substantial period of observation, individuals with two consecutive encounters >18 months apart or with < 2 yr of observation were excluded. SCD genotype (SS, SC, and Sβ0 and Sβ+ thalassemia) was confirmed for each patient by review of hematologic and clinical data, including results of diagnostic hemoglobin electrophoresis; those with rare SCD genotypes (e.g. SD, SE) were excluded. The primary cause for each admission was determined through medical chart review and classified into 4 mutually exclusive hierarchical categories in the following descending order: acute chest syndrome (ACS), pain crisis, fever/infection, and other complications of SCD (i.e. an admission for both pain and ACS was categorized as ACS). Scheduled hospitalizations for elective procedures (e.g. splenectomy, cholecystectomy, venous catheter placement) were excluded. A readmission was defined as a hospitalization occurring within 7, 14, or 30 days of a previous hospital discharge. Results: The analysis included 1,331 individuals with 5,362 person-years of observation; 68% had SS/Sβ0 thal genotypes, 49% were male. Age at the time of the earliest encounter ranged from 2 months to 19 years; average length of observation was 4.02 years (min, max= 2, 5). Total n of hospital admissions was 5,317; 19.4% were never hospitalized, and 44.8% were hospitalized less than once per year. The most common primary cause for hospital admission was pain (53.1% of admissions). Overall and cause-specific hospitalization rates varied by age and genotype (Figure) with overall hospitalization rates lowest among children 4-9 years old compared to other ages (0.68 vs. 1.00 admissions per person-year) and highest among those with SS or Sβ0 thal compared to those with SC or Sβ+ thal (0.97 vs. 0.68 admissions per person-year). Hospitalization rates associated with pain increased with age while rates for fever/infection decreased with age. Of the 1,073 patients who were admitted, 356 were readmitted within 30 days of a previous admission at least once. All-cause 7-, 14- and 30-day readmission rates were 5.6%, 10.0% and 18.2%, respectively. 30-day readmission rates were lower among younger age groups (15.7% for age 1-3 yr, 15.3% for 4-6 yr, 15.8% for 7-9 yr) but higher in older patients (18.3% for 10-12yr, 19.9% for 13-15yr, and 23.3% for 16-18yr). Readmission rates were highest following index admissions for pain (20.4%) and lowest for ACS (11.3%). Gender was not associated with readmission or cause of readmission. Conclusion: SCD-related hospitalization rates were highest in early life and in later adolescence with admissions for fever/infection most common in younger children and admissions for pain crises in older children. Rates of readmission strongly correlated with age and were highest following admissions for pain. These data highlight to need to develop and implement improved strategies prevention and treatment of pain in children and adolescents with SCD. Further studies should also explore individual and/or family factors that may contribute to the high rates of hospital utilization and 30-day readmissions that occur among a relatively small percentage of patients. Figure 1. Hospitalization rate per person-year by type of admission and age Figure 1. Hospitalization rate per person-year by type of admission and age Disclosures No relevant conflicts of interest to declare.

scholarly journals P051: A chart review of emergency department visits following implementation of the Cannabis Act in Canada

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S82-S82
Author(s):  
M. O'Brien ◽  
P. Rogers ◽  
E. Smith
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Emergency Department Visits ◽  
Health Science ◽  
Cannabis Use ◽  
Public Health Agencies ◽  
Hospitalization Rates ◽  
Significant Difference ◽  
Cannabinoid Hyperemesis Syndrome ◽  
Recreational Use

Introduction: The legalization of cannabis for recreational use in 2018 remains a controversial topic. There are multiple perceived benefits of cannabis including pain relief, treatment of epilepsy syndromes, and improving body weight of cancer patients. However, there are also many potential risks. The short-term health consequences include cannabinoid hyperemesis syndrome and cannabis induced psychosis. These conditions directly impact the influx of patients presenting to Emergency Departments (ED). There is currently limited research in the area of cannabis legalization burden. However, the studies performed have shown a significant impact in those states which cannabis is legal. A study completed in Colorado found that hospitalization rates with marijuana related billing codes increased from 274 to 593 per 100 000 hospitalizations after the state legalization of recreational cannabis. This study aims to examine if Canada's hospitals are experiencing the same burden as other jurisdictions. Methods: A descriptive study was preformed via a retrospective chart review of cannabis related visits in tertiary EDs in St. John's, NL, from six months prior to the date of legalization of cannabis for recreational use, to six months after. Hospital ED visit records from both the Health Science Centre and St. Clare's Mercy Hospital were searched using keywords to identify patients who presented with symptoms related to cannabis use. We manually reviewed all visit records that included one or more of these terms to distinguish true positives from false positive cases, unrelated to cannabis use. Results: A total of 287 charts were included in the study; 123 visits were related to cannabis use six months prior to legalization, and 164 six months after legalization. A significant increase in ED visits following the legalization of recreational cannabis was seen (p < .001). There was no significant difference in the age of users between the two groups. Additionally, the number one presenting complaint due to cannabis use was vomiting (47.7%), followed by anxiety (12.2%). Conclusion: Following the implementation of the Cannabis Act in Canada, EDs in St. John's, NL had a statistically significant increase in the number of visits related to cannabis use. It is important to determine such consequences to ensure hospitals and public health agencies are prepared to treat the influx of visits and are better equipped to manage the associated symptoms.

scholarly journals Comparison of Solute Clearance, Hospitalization Rate, and Aortic Arch Calcification between Online Hemodiafiltration and High-Flux Hemodialysis: A 6-Year Observational Study

2019 ◽  
Vol 44 (2) ◽  
pp. 264-276
Author(s):  
Na Hao ◽  
Cheng-Hong Yang ◽  
Hong-Tao Yang ◽  
Chien-Hsing Wu ◽  
Yang-Yang Lei ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Hospitalization Rate ◽  
High Flux ◽  
Cox Proportional Hazard ◽  
Hospitalization Rates ◽  
Significant Difference ◽  
Clinical Benefits ◽  
Laboratory Variables ◽  
Cox Proportional Hazard Regression ◽  
Aortic Arch Calcification

Background/Aims: Studies on the long-term clinical benefits of hemodiafiltration (HDF) and high-flux hemodialysis (HFHD) are very limited. This study aimed to investigate the hospitalization rate and aortic arch calcification (AAC) of these two dialysis modalities over 6 years. Methods: Participants who received regular HDF and HFHD in one hospital-facilitated hemodialysis center were prospectively enrolled after matching for age, sex, and diabetes between January 2009 and December 2014. Medical records were reviewed retrospectively on demographics, laboratory variables, calcified scores in aortic arch measured by chest radiography, and rates of hospital admission. Cox proportional hazard regression and linear regression were used to obtain the outcome results. Results: The HDF and HFHD groups consisted of 108 and 102 participants, respectively. Levels of laboratory variables including small soluble solutes and Kt/V were not statistically different over the 6-year period between the HDF and HFHD groups. Calcified scores of the aortic arch increased over 6 years in both groups. The changes in the mean calcified scores were significant when compared between the two groups (0.44–1.82 in HFHD, 0.79–1.8 in HDF, respectively, p = 0.008). Hospitalization rates were 735 per 1,000 patients in the HDF group and 852 per 1,000 patients in the HFHD group, respectively. No significant difference was observed in frequency and days of hospitalization between HDF and HFHD. Conclusion: Hospitalization rates and AAC were observed to be equal for HDF and HFHD.

160: Evaluation of an Oral Morphine Protocol in Early Treatment of Acute Pain Crisis in Sickle Cell Patients in the Outpatient Setting

2015 ◽  
Vol 20 (5) ◽  
pp. e92-e92
Author(s):  
H Paquin ◽  
E Doyon-Trottier ◽  
Y Pastore ◽  
N Robitaille ◽  
MJ Dore-Bergeron ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Acute Pain ◽  
Early Treatment ◽  
Oral Morphine ◽  
Outpatient Setting ◽  
Pain Crisis

Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study

2020 ◽  
Vol 132 (5) ◽  
pp. 1405-1413 ◽  
Author(s):  
Michael D. Staudt ◽  
Holger Joswig ◽  
Gwynedd E. Pickett ◽  
Keith W. MacDougall ◽  
Andrew G. Parrent
Keyword(s):  
Multiple Sclerosis ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Retrospective Chart Review ◽  
Medication Usage ◽  
Free Response ◽  
Free Survival ◽  
Time To Recurrence ◽  
Significant Difference

OBJECTIVEThe prevalence of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS-TN) is higher than in the general population (idiopathic TN [ITN]). Glycerol rhizotomy (GR) is a percutaneous lesioning surgery commonly performed for the treatment of medically refractory TN. While treatment for acute pain relief is excellent, long-term pain relief is poorer. The object of this study was to assess the efficacy of percutaneous retrogasserian GR for the treatment of MS-TN versus ITN.METHODSA retrospective chart review was performed, identifying 219 patients who had undergone 401 GR procedures from 1983 to 2018 at a single academic institution. All patients were diagnosed with medically refractory MS-TN (182 procedures) or ITN (219 procedures). The primary outcome measures of interest were immediate pain relief and time to pain recurrence following initial and repeat GR procedures. Secondary outcomes included medication usage and presence of periprocedural hypesthesia.RESULTSThe initial pain-free response rate was similar between groups (p = 0.726): MS-TN initial GR 89.6%; MS-TN repeat GR 91.9%; ITN initial GR 89.6%; ITN repeat GR 87.0%. The median time to recurrence after initial GR was similar between MS-TN (2.7 ± 1.3 years) and ITN (2.1 ± 0.6 years) patients (p = 0.87). However, there was a statistically significant difference in the time to recurrence after repeat GR between MS-TN (2.3 ± 0.5 years) and ITN patients (1.2 ± 0.2 years; p < 0.05). The presence of periprocedural hypesthesia was highly predictive of pain-free survival (p < 0.01).CONCLUSIONSPatients with MS-TN achieve meaningful pain relief following GR, with an efficacy comparable to that following GR in patients with ITN. Initial and subsequent GR procedures are equally efficacious.

Incidence of nonaccidental head trauma in infants: a call to revisit prevention strategies

2019 ◽  
Vol 24 (6) ◽  
pp. 689-696 ◽  
Author(s):  
LaVerne W. Thompson ◽  
Kathryn D. Bass ◽  
Justice O. Agyei ◽  
Hibbut-Ur-Rauf Naseem ◽  
Elizabeth Borngraber ◽  
...  
Keyword(s):  
New York ◽  
Parent Education ◽  
Shaken Baby Syndrome ◽  
Retrospective Chart Review ◽  
Educational Interventions ◽  
Significant Rise ◽  
Significant Incidence ◽  
Significant Difference ◽  
Icd 10 ◽  
Parent Education Programs

OBJECTIVETraumatic brain injury is a major sequela of nonaccidental trauma (NAT) that disproportionately affects young children and can have lasting sequelae. Considering the potentially devastating effects, many hospitals develop parent education programs to prevent NAT. Despite these efforts, NAT is still common in Western New York. The authors studied the incidence of NAT following the implementation of the Western New York Shaken Baby Syndrome Education Program in 1998.METHODSThe authors performed a retrospective chart review of children admitted to our pediatric hospital between 1999 and 2016 with ICD-9-CM and ICD-10-CM codes for types of child abuse and intracranial hemorrhage. Data were also provided by the Safe Babies New York program, which tracks NAT in Western New York. Children with a diagnosis of abuse at 0–24 months old were included in the study. Children who suffered a genuine accidental trauma or those with insufficient corroborating evidence to support the NAT diagnosis were excluded.RESULTSA total of 107 children were included in the study. There was a statistically significant rise in both the incidence of NAT (p = 0.0086) and the incidence rate of NAT (p = 0.0235) during the study period. There was no significant difference in trendlines for annual NAT incidence between sexes (y-intercept p = 0.5270, slope p = 0.5263). When stratified by age and sex, each age group had a distinct and statistically significant incidence of NAT (y-intercept p = 0.0069, slope p = 0.0374).CONCLUSIONSDespite educational interventions targeted at preventing NAT, there is a significant rise in the trend of newly reported cases of NAT, indicating a great need for better injury prevention programming.

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