Maxillofacial Trauma Resulting from Physical Violence against Older Adults: A 4-year Study in a Brazilian Forensic Service

Rayanne Izabel Maciel de Sousa, Italo Macedo Bernardino, Ricardo Dias de Castro, Alessandro Leite Cavalcanti, Patricia Meira Bento, Sergio d'Avila

Abstract


Objective: To evaluate the prevalence of maxillofacial trauma resulting from physical violence against older adults, describe patterns and identify factors associated with its occurrence. Material and Methods: This is a cross-sectional study conducted from the assessment of 7,132 reports of victims of violence who sought a Brazilian Service of Forensic Medicine and Dentistry, during the period from January 2008 to December 2011. Descriptive statistics, Pearson’s chi-test square test and Poisson’s univariate and multivariate regression (with robust variance) were performed using SPSS software version 20.0. The significance level was set at p <0.05. Results: A total of 259 older adults suffered physical violence. The occurrence of maxillofacial trauma was observed in 42.9% of the sample. Lesions in soft tissue (90.1%) affecting more than one region of the face (40.4%) were the most frequent. The prevalence of maxillofacial trauma was more frequent among individuals older than 66 years (PR = 1.166; 95% CI = 0.865-1.572), males (PR = 1.119; 95% CI = 0.807-1.550), victims of violence occurred within the community (PR = 1.431; 95% CI = 0.951- 2.153), during the night shift (PR = 1.226; 95% CI = 0.911-1.651) and weekends (PR = 1.279; 95% CI = 0.955-1.714) performed without using blunt instrument (PR = 1.311; 95% CI = 0.932-1.846). Conclusion: The prevalence of maxillofacial trauma resulting from physical violence against older adults was high and soft tissue lesions affecting more than one face region were predominant


Keywords


Violence; Elder Abuse; Maxillofacial Injury

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References


Jin Z, Jiang X, Shang L. Analysis of 627 hospitalized maxillofacial-oral injuries in Xi'an, China. Dent Traumatol 2014; 30(2):147-53.

Mascarenhas MD, Silva MM, Malta DC, Moura LD, Goes PS, Moysés ST, et al. Epidemiological profile of emergency care for dental and oral injuries in Brazil, 2006-2007. Cad Saude Publica 2012; 28:124-32.

World Health Organization (WHO). Guidelines for conducting community surveys on injuries and violence. Geneva: WHO; 2004.

Fraade-Blanar L, Concha-Eastman A, Baker T. Injury in the Americas: the relative burden and challenge. Rev Panam Salud Publica 2007; 22(4):254-9.

de Freitas MG, Bonolo PF, de Moraes EN, Machado CJ. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents. Cien Saude Colet 2015; 20(3):701-12.

Lee KH. Interpersonal violence and facial fractures. J Oral Maxillofac Surg 2009; 67(9):1878-83.

O'Meara C, Witherspoon R, Hapangama N, Hyam DM. Alcohol and interpersonal violence may increase the severity of facial fracture. Br J Oral Maxillofac Surg 2012; 50(1):36-40.

Brasil. Ministério da Saúde. Política Nacional de Redução da Morbimortalidade por Acidentes e Violências. 2. ed. Brasília: Brasil; 2005.

Lima MLC. About the national health policy for reducing accidents and violence nowadays. Cien Saude Colet. 2009;14(5):1654-5.

Li R, Zhang R, Li W, Pei F, He W. Analysis of 126 hospitalized elder maxillofacial trauma victims in central China. Med Oral Patol Oral Cir Bucal 2015; 20(4):464-70.

Gawryszewski VP, Rodrigues EM. The burden of injury in Brazil, 2003. Sao Paulo Med J 2006; 124(4):208-13.

Brasil. Lei 3689. Código do Processo Penal. Brasília: Brasil; 1941.

Silva CJ, Ferreira RC, de Paula LP, Haddad JP, Moura AC, Naves MD, et al. Maxillofacial injuries as markers of urban violence: a comparative analysis between the genders. Cien Saude Colet 2014; 19(1):127-36.

Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 2003; 3:21.

Oikarinen K, Schutz P, Thalib L, Sándor GK, Clokie C, Meisami T, et al. Differences in the etiology of mandibular fractures in Kuwait, Canada, and Finland. Dent Traumatol 2004; 20(5):241-5.

Ogundare BO, Bonnick A, Bayley N. Pattern of mandibular fractures in an urban major trauma center. J Oral Maxillofac Surg 2003; 61(6):713-8.

Li YS, Tian WD, Li SW, Liu L. Retrospective analysis of 3,958 patients with facial injuries. Zhonghua Kou Qiang Yi Xue Za Zhi 2006; 41(7):385-7.

Shaw FE. Falls in cognitive impairment and dementia. Clin Geriatr Med 2002; 18(2):159-73.

Wade CV, Hoffman GR, Brennan PA. Falls in elderly people that result in facial injuries. Br J Oral Maxillofac Surg 2004; 42(2):138-41.

Klopfstein U, Kamber J, Zimmermann H. On the way to light the dark: a retrospective inquiry into the registered cases of domestic violence towards women over a six year period with a semi-quantitative analysis of the corresponding forensic documentation. Swiss Med Wkly 2010; 140:1-7.

Abath MB, Leal MC, Melo Filho DA, Marques AP. Physical abuse of older people reported at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil. Cad Saude Publica 2010; 26(9):1797-806.

Anyanechi CE. Mandibular fractures associated with domestic violence in calabar, Nigeria. Ghana Med J 2010; 44(4):155-8.

Carlson J, Casey E, Edleson JL, Tolman RM, Walsh TB, Kimball E. Strategies to Engage Men and Boys in Violence Prevention: A Global Organizational Perspective. Violence Against Women 2015; 21(11):1406-25.

Selic P, Pesjak K, Kersnik J. The prevalence of exposure to domestic violence and the factors associated with co-occurrence of psychological and physical violence exposure: a sample from primary care patients. BMC Public Health 2011; 11:621.

Gaioli CC, Rodrigues RA. Occurrence of domestic elder abuse. Rev Lat Am Enfermagem 2008; 16(3):465-70.

Karsch UM. Dependent seniors: families and caregivers. Cad Saude Publica 2003;19(3): 861-866.

Velayutham L, Sivanandarajasingam A, O'Meara C, Hyam D. Elderly patients with maxillofacial trauma: the effect of an ageing population on a maxillofacial unit's workload. Br J Oral Maxillofac Surg 2013; 51(2):128-32.

Cecilio LPP, Garbin CAS, Rovida TAS, Queiróz APDG, Garbin AJÍ. Interpersonal violence: descriptive study of not fatal cases assisted in an emergency reference unity to seven municipalities of the state of São Paulo, Brazil, from 2008 to 2010. Epidemiol Serv Saúde 2012; 21(2):293-304.




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