Impact of the COVID-19 lockdown period on hospital admissions for pediatric injuries: a French nationwide study

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K. Fall, Marguerite Lockhart-Bouron, Laure Lacan, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4762515/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 04 Dec, 2024 Read the published version in European Journal of Pediatrics → Version 1 posted 11 You are reading this latest preprint version Abstract PURPOSE During the COVID-19 pandemic, lockdown posed a number of unprecedented problems. Injuries to children are a major public health concern. This study sought to determine the impact of France’s 2020 COVID-19 lockdown on hospital admissions for paediatric injuries. METHODS This study was a retrospective cohort analysis of data from the French national inpatient database. Children admitted to a French hospital for an injury from January to July 2020 and 2019 were included. The number of admissions for injuries between January and July in 2020 (the study period) vs. the same period (the control period) in 2019 were recorded. Hospital admission rate ratios (HRRs) comparing 2020 with 2019 were calculated for three periods: before lockdown (January 1st to March 15th ), during lockdown (March 16th to May 10th ), and after lockdown (May 11th to July 31st ]). RESULTS A total of 72089 children were admitted to hospital for injuries between January and July 2020 (mean (SD) age, 8.7 (5.8)), and 84961 between January and July 2019 (mean (SD) age, 9.2 (5.7)). 12864 children (18%) were admitted during the lockdown period in 2020, and 23098 (27%) during the equivalent period in 2019 (HRR, 0.56; 95% confidence interval (CI), 0.55–0.57; p < .001). During the 2020 lockdown, the risk of injury–related paediatric admissions with critical care lasting for at least 1 day was lower than in 2019 (HRR 0.67; 95%CI, 0.62–0.73; p < .001). CONCLUSIONS Further research could usefully examine how parents create a safe home environment for their children. COVID-19 Paediatric Injury Paediatric intensive care Figures Figure 1 Figure 2 Figure 3 What is Known During the COVID-19 pandemic, lockdown posed a number of unprecedented problems. Injuries to children are a major public health concern. This study sought to determine the impact of France’s 2020 COVID-19 lockdown on hospital admissions for pediatric injuries. What is New The first nationwide COVID-19 lockdown in France was associated with a decrease in the absolute number of hospital admissions for pediatric injuries, for all age groups, as well as the number of injury–related pediatric hospital stays involving critical care. INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic was an international public health emergency. Guided by the World Health Organization, many countries implemented periods of “lockdown” to control the spread of the disease. In France, the first period of strict lockdown ran from March 16th to May 10th, 2020. Following the introduction of emergency legislation, people were confined to their homes, and outdoor movement was restricted to essential activities (including medical care). Most accidents involving children or injuries to children occur (i) during domestic accidents (include poisoning, burns, suffocation by foreign bodies, falls, and drowning) at home or in the immediate surroundings (the garden, yard, or garage), (ii) away from the home (e.g. at school or during sports activities); and (iii) on vacation [ 1 ]. The French Academy of Medicine has reported that since the implementation of COVID-19 containment measures, the emergency services, firefighters and media have reported an increase in domestic accidents [ 2 ]. However, the literature data on the number of children attending hospital for an injury during the lockdown period are contradictory, with both increases and decreases reported [ 3 , 4 ]. Moreover, all the studies of this topic in France were conducted at single centres, and nationwide data are lacking [ 5 , 6 ]. In view of these gaps in our knowledge, we decided to perform a large, nationwide, population-based cohort study. We hypothesized that the number of injury–related hospital admissions among children and teenagers would decrease during France’s first period of nationwide COVID-19 lockdown, as a results of changes in social behaviour and mobility. The primary objective was to describe the impact of France’s first period of COVID-19 lockdown on the number of injury-related hospital admissions of children. The secondary objectives were to perform stratified analyses by age group. METHODS Data source In the present retrospective cohort study, we analysed data extracted from the French national inpatient database ( Programme de Medicalisation des Systèmes d’Information (PMSI)) [ 7 ]. The PMSI is populated with information on diagnoses and medical procedures from standardized hospital discharge reports. The coding and reporting of this information is mandatory in all hospital departments. The discharge report abstracts in the PMSI include the patients’ demographic characteristics, diagnostic codes (based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10]), and medical procedure codes (based on the French Classification Commune des Actes Médicaux ). To ensure that the data are of high quality, routine tests are performed when information on inpatient stays is sent to the French public health insurance agency. These tests include checks on the chronology of the hospital stays, the format of the demographic characteristics (missing, incorrect or inaccurate values for the sex, age, date, mode of entry, and date and mode of discharge), the format and accuracy of procedure and diagnostic codes, and the coherence of the relationships between procedure codes, diagnostic codes, the length of hospital stay, age, and sex. The University of Lille institutional review board waived the need for informed consent because the study used de-identified medical data and did not involve human participant research. The study was reported in line with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines Participants The study included paediatric patients (from 1 day to 17 years of age) admitted to hospital for injuries (including domestic accidents like trauma, intoxication, poisoning, and drowning) in metropolitan France from January 1st to July 31st, 2019 (the control period) and from January 1st to July 31st, 2020 (the study period). The diagnostic codes are given in eTable 1 . The four age subgroups studied were below 1 year of age, 2 to 5, 6 to 12, and 13 to 17. The exclusion criteria were an incorrect patient identifier, an incorrect French diagnosis-related group, and death less than 1 day after delivery. Consecutive hospital stays for which the time interval between stays was less than 1 day were considered to be a single stay. The start of the care sequence was defined as the starting date of the first stay, and the end date was defined as the date of death or the date of discharge at the end of the last stay. Exposures of Interest The main exposure of interest was the year 2020 vs. the year 2019. For the two years, three periods (Ps) were considered: January 1st to March 15th (before the lockdown, referred to hereafter as P1), March 16th to May 10th (during the lockdown, P2), and May 11th to July 31st (after the lockdown, P3). The patient’s sex, age, and hospital status were reported, together with whether the patient had died during the hospital stay. Critical care was defined as admission to a paediatric intensive care unit (PICU) or a paediatric intermediate care unit. During a given hospital stay, a patient could be admitted to both a PICU and a paediatric intermediate care unit. The primary outcome was the number of injury–related hospital stays lasting 1 day or more for children in France from March 16th to May 10th, 2020. The secondary outcome was the number of these admissions involving critical care. Statistical analysis Categorical variables were expressed as the frequency (percentage), and continuous variables were expressed as the mean (standard deviation (SD)). The hospital admission rate ratio (HRR) for the study period vs. the control period was calculated for P1, P2 and P3, i.e. before lockdown, during lockdown, and after lockdown, respectively. The secondary outcomes were the changes in HRRs stratified by age group. For each interval and each modality of the secondary outcome variables, HRRs comparing the study period with the control period were calculated by using Poisson regression to model the overall number of hospital admissions. All tests were two-tailed, and the threshold for statistical significance was set to P < .05. All statistical analyses were performed using R software (version 4.3.0) [ 8 ]. RESULTS Characteristics of patients admitted for injuries from January to July in 2020 vs. 2019 In France, a total of 166126 hospital stays for paediatric injuries were recorded from January 1 st to July 31 st , 2019, and from January 1 st to July 31 st , 2020 ( Table 1 ). Table 1 . Characteristics of Patients with Paediatric Injuries Before, During, and After the First Period of COVID-19 Lockdown in France. Total Before lockdown (P1) During lockdown (P2) After lockdown (P3) Characteristics 2019 2020 P Value 2019 2020 P Value 2019 2020 P Value 2019 2020 P Value All (n) 84 961 72089 26268 25584 23098 12864 35595 33641 Age (year) <.0001 0.3230 <.0001 <.0001 Mean (SD) 9.2 (5.7) 8.7 (5.8) 9.5 (5.8) 9.6 (5.8) 9.3 (5.7) 7.2 (5.5) 9.0 (5.7) 8.7 (5.7) Range 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 Median (IQR) 10.0 (4.0-15.0) 9.0 (3.0-14.0) 11.0 (4.0-15.0) 11.0 (4.0-15.0) 10.0 (4.0-15.0) 6.0 (2.0-12.0) 10.0 (4.0-14.0) 9.0 (3.0-14.0) Age categories n (%) <.0001 0.1818 <.0001 <.0001 Below 1 year 12073 (14.2) 11682 (16.2) 3894 (14.8) 3813 (14.9) 3151 (13.6) 2532 (19.7) 5028 (14.1) 5337 (15.9) 2-5 years 14950 (17.6) 13852 (19.2) 4275 (16.3) 3991 (15.6) 4152 (18.0) 3351 (26.0) 6524 (18.3) 6509 (19.3) 6-12 years 25183 (29.6) 21221 (29.4) 7092 (27.0) 6906 (27.0) 6895 (29.9) 3941 (30.6) 11196 (31.5) 10374 (30.8) 13-17 years 32754 (38.6) 25335 (35.1) 11007 (41.9) 10874 (42.5) 8900 (38.5) 3040 (23.6) 12847 (36.1) 11421 (33.9) Sex n (%) 0.9866 0.1655 <.0001 0.3153 Girl 33984 (40.0) 28833 (40.0) 10999 (41.9) 10559 (41.3) 9285 (40.2) 5449 (42.4) 13701 (38.5) 12824 (38.1) Boy 50976 (60.0) 43257 (60.0) 15269 (58.1) 15025 (58.7) 13813 (59.8) 7415 (57.6) 21894 (61.5) 20817 (61.9) Length of hospital stay <.0001 <.0001 0.2957 0.0592 Mean (SD) 1.6 (4.3) 1.6 (4.6) 1.8 (4.7) 1.7 (4.8) 1.6 (4.6) 1.7 (5.1) 1.5 (4.2) 1.5 (4.0) Range 0.0-203.0 0.0-293.0 0.0-151.0 0.0-277.0 0.0-293.0 0.0-227.0 0.0-173.0 0.0-193.0 Median (IQR) 1.0 (0.0-1.0) 1.0 (0.0-1.0) 1.0 (0.0-2.0) 1.0 (0.0-1.0) 1.0 (0.0-1.0) 1.0 (0.0-1.0) 1.0 (0.0-1.0) 1.0 (0.0-1.0) Length of hospital stay (days in classes) (%) <.0001 0.0001 0.0002 0.0068 < 1 32781 (38.6) 28306 (39.3) 10199 (38.8) 10405 (40.7) 8922 (38.6) 4924 (38.3) 13660 (38.4) 12977 (38.6) 1 <2 32106 (37.8) 27598 (38.3) 9381 (35.7) 8969 (35.1) 8722 (37.8) 5107 (39.7) 14003 (39.3) 13522 (40.2) 2 <3 days 8540 (10.1) 6998 (9.7) 2587 (9.8) 2448 (9.6) 2257 (9.8) 1219 (9.5) 3696 (10.4) 3331 (9.9) ≥3 11533 (13.6) 9188 (12.7) 4101 (15.6) 3762 (14.7) 3197 (13.8) 1614 (12.5) 4236 (11.9) 3811 (11.3) Death in hospital n (%) 0.2370 0.8576 0.3035 0.0199 No 84797 (99.8) 71970 (99.8) 26219 (99.8) 25538 (99.8) 23059 (99.8) 12836 (99.8) 35520 (99.8) 33595 (99.9) Yes 163 (0.2) 120 (0.2) 49 (0.2) 46 (0.2) 39 (0.2) 28 (0.2) 75 (0.2) 46 (0.1) Admissions with critical care n (%) <.0001 0.9654 <.0001 0.0021 No 79190 (93.2) 66796 (92.7) 24484 (93.2) 23844 (93.2) 21546 (93.3) 11815 (91.8) 33160 (93.2) 31137 (92.6) Yes 5770 (6.8) 5294 (7.3) 1784 (6.8) 1740 (6.8) 1552 (6.7) 1049 (8.2) 2435 (6.8) 2504 (7.4) Admissions to a PICU n (%) 0.0757 0.2721 0.0099 0.0618 No 82955 (97.6) 70289 (97.5) 25631 (97.6) 25001 (97.7) 22569 (97.7) 12513 (97.3) 34756 (97.6) 32774 (97.4) Yes 2005 (2.4) 1801 (2.5) 637 (2.4) 583 (2.3) 529 (2.3) 351 (2.7) 839 (2.4) 867 (2.6) Admissions to a paediatric intermediate care unit n (%) <.0001 0.7190 <.0001 0.0012 No 80819 (95.1) 68222 (94.6) 24981 (95.1) 24313 (95.0) 21980 (95.2) 12092 (94.0) 33858 (95.1) 31817 (94.6) Yes 4141 (4.9) 3868 (5.4) 1287 (4.9) 1271 (5.0) 1118 (4.8) 772 (6.0) 1737 (4.9) 1824 (5.4) Surgery n (%) 0.4051 0.0243 0.5774 0.0006 No 42625 (50.2) 36320 (50.4) 13795 (52.5) 13183 (51.5) 11618 (50.3) 6431 (50.0) 17212 (48.4) 16706 (49.7) Yes 42335 (49.8) 35770 (49.6) 12473 (47.5) 12401 (48.5) 11480 (49.7) 6433 (50.0) 18383 (51.6) 16935 (50.3) Abbreviations: SD, standard deviation; IQR: interquartile range; PICU: paediatric intensive care unit. After the exclusion of stays that did not meet the study’s criteria, 157050 hospital stays were included in our analysis ( Figure 1 ). In 2020, 72089 hospital stays for injuries were recorded (mean (SD) patient age, 8.7 (5.8) years; females: 40%), and the mean (SD) length of stay was 1.6 (4.6) days). In 2019, 84961 hospital stays for injuries were recorded (mean (SD) age, 9.2 (5.7) years; females: 40%), with a mean (SD) length of stay was 1.6 (4.3) days. The number of hospitals stays for injuries was 12864 for P2 in 2020 (mean (SD) patient age: 7.2 (5.5) years) and 23098 for P2 in 2019 (mean (SD) patient age: 9.3 (5.7) years; HRR, 0.56; 95%CI, 0.55-0.57; p < .001) ( Figure 2 ). The number of traumatic head injuries fell by 45%. The number of traumatic ankle and foot injuries fell by between 29%, the number of traumatic neck injuries fell by 70%, and the number of drug poisoning and toxic events decreased by between 30% and 50% ( eTable 2 ). During P2, the mortality rates were low and similar in 2020 and 2019 (0.2%), and the year-on-year difference in the incidence of surgery (50% in 2020 vs. 49.7% in 2019) was not significant. For P1 and P3, there were significantly fewer admissions for injuries in 2020 than in 2019; the HRR was 0.97 (95%CI, 0.96-0.99; p = .003) for P1 and 0.95 (95%CI, 0.93-0.96; p < .001) for P3 ( Figure 2 ). Injury–related hospital stays with critical care lasting ≥ 1 day from January to July in 2020 vs. 2019 A total of 4874 paediatric admissions with at least one stay in a critical care unit were recorded in 2020 (1606 in P1, 958 in P2, and 2310 in P3), and 5302 were recorded in 2019 (1632 in P1, 1430 in P2, and 2240 in P3) ( Table 2 ). Table 2 . Characteristics of Paediatric Patients Admitted to a Critical Care Unit for At Least 1 Day Before, During, and After the First Period of COVID-19 Lockdown in France. Before lockdown (P1) During lockdown (P2) After lockdown (P3) Characteristics 2019 2020 P Value 2019 2020 P Value 2019 2020 P Value All (n) 1 632 1606 1430 958 2240 2310 Age (year) 0.6621 <.0001 0.0057 Mean (SD) 8.7 (6.5) 8.8 (6.4) 8.8 (6.3) 6.8 (6.2) 8.8 (6.2) 8.3 (6.2) Range 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 0.0-17.0 Median (IQR) 10.0 (1.0-15.0) 10.0 (2.0-15.0) 10.0 (2.0-15.0) 5.0 (1.0-13.0) 10.0 (2.0-15.0) 8.0 (2.0-14.0) Age categories n (%) 0.2583 <.0001 0.0008 Below 1 year 421 (25.8) 386 (24.0) 296 (20.7) 298 (31.1) 467 (20.8) 515 (22.3) 2-5 years 218 (13.4) 241 (15.0) 250 (17.5) 206 (21.5) 377 (16.8) 441 (19.1) 6-12 years 314 (19.2) 285 (17.7) 307 (21.5) 183 (19.1) 475 (21.2) 539 (23.3) 13-17 years 679 (41.6) 694 (43.2) 577 (40.3) 271 (28.3) 921 (41.1) 815 (35.3) Sex n (%) 0.2877 0.0693 0.1733 Female 760 (46.6) 718 (44.7) 603 (42.2) 440 (45.9) 918 (41.0) 901 (39.0) Male 872 (53.4) 888 (55.3) 827 (57.8) 518 (54.1) 1322 (59.0) 1409 (61.0) Length of hospital stay n (%) 0.4506 0.3496 0.0380 Mean (SD) 7.4 (12.1) 8.0 (14.5) 7.4 (13.9) 7.5 (14.1) 6.4 (12.2) 6.6 (11.3) Range 1.0-146.0 1.0-277.0 1.0-293.0 1.0-227.0 1.0-173.0 1.0-193.0 Median (IQR) 3.0 (1.0-8.0) 3.0 (1.0-9.0) 3.0 (1.0-8.0) 3.0 (1.0-9.0) 3.0 (1.0-7.0) 3.0 (1.0-7.0) Length of hospital stay (days, in classes) n, (%) 0.8608 0.0930 0.0559 1-<2 471 (28.9) 460 (28.6) 389 (27.2) 298 (31.1) 731 (32.6) 722 (31.3) 2-<3 231 (14.2) 218 (13.6) 217 (15.2) 147 (15.3) 377 (16.8) 344 (14.9) ≥3 930 (57.0) 928 (57.8) 824 (57.6) 513 (53.5) 1 132 (50.5) 1 244 (53.9) Death in hospital n (%) 0.2620 0.0589 0.3843 No 1607 (98.5) 1573 (97.9) 1415 (99.0) 939 (98.0) 2204 (98.4) 2280 (98.7) Yes 25 (1.5) 33 (2.1) 15 (1.0) 19 (2.0) 36 (1.6) 30 (1.3) Admissions to a PICU n (%) 0.2243 0.5578 0.3558 No 1047 (64.2) 1063 (66.2) 951 (66.5) 626 (65.3) 1476 (65.9) 1492 (64.6) Yes 585 (35.8) 543 (33.8) 479 (33.5) 332 (34.7) 764 (34.1) 818 (35.4) Admissions to a paediatric intermediate care unit n (%) 0.7168 0.7952 0.5963 No 437 (26.8) 421 (26.2) 377 (26.4) 248 (25.9) 611 (27.3) 614 (26.6) Yes 1195 (73.2) 1185 (73.8) 1053 (73.6) 710 (74.1) 1629 (72.7) 1696 (73.4) Surgery n (%) 0.3037 0.5507 0.0922 No 1133 (69.4) 1088 (67.7) 1006 (70.3) 663 (69.2) 1557 (69.5) 1552 (67.2) Yes 499 (30.6) 518 (32.3) 424 (29.7) 295 (30.8) 683 (30.5) 758 (32.8) Abbreviations: SD, standard deviation; IQR: interquartile range; PICU: paediatric intensive care unit. For P2, the risk of an injury–related hospital stays with critical care lasting for at least 1 day was lower in 2020 than in 2019 (HRR 0.67; 95%CI, 0.62-0.73; p < .001) ( Figure 3 ). The mean (SD) patient age was 6.8 (6.2) in 2020 and 8.8 (6.3) in 2019 (p < .001). The mean (SD) length of stay with critical care was (7.5 (14.1) days in 2020 and 7.4 (13.9) days in 2019; this difference was not significant (p = 0.35). Likewise, the year-on-year difference in the proportion of patients having undergone surgery during P2 was not significant (30.8% in 2020 vs. 29.7% in 2019; p = 0.55). For P1 and P3, the numbers of paediatric admissions with at least one stay in a critical care unit were similar in 2020 and 2019 ( Figure 3 ). Stratified analyses When the absolute number of injuries was stratified by age, the lockdown period comprised fewer admissions in 2020 than in 2019 for all age groups ( Tables 1 and 2, and Figure 2 ). The largest decreases were observed for teenagers (aged 13-17; HRR, 0.34; 95%CI, 0.33-0.36; p < .001) and for 6- to 12-year-olds (HRR, 0.57; 95%CI, 0.55-0.59; p < .001). During P1, the number of admissions was similar in 2020 and 2019 for all age groups other than the 2-to 5-year-olds (HRR, 0.93; 95%CI, 0.89-0.97; p = 0.002). During P3, there were more admissions in 2020 than in 2019 for the youngest children (below 1 year of age; HRR, 1.06; 95%CI, 1.02-1.10; p = 0.002) and fewer admissions for 6- to 12-year-olds (HRR, 0.93; 95%CI, 0.90-0.95; p < .0001) and teenagers (HRR, 0.89; 95%CI, 0.87-0.91; p < .0001). We next stratified the data for injury–related hospital stays involving at least 1 day of critical care by age group ( Figure 3 ): the most significant fall from 2020 to 2019 during P2 was again observed for teenagers (HRR, 0.47; 95%CI, 0.41-0.54; p < .001) and 6- to 12-year-olds (HRR, 0.60; 95%CI, 0.50-0.71; p < .001). During P1, the numbers of injuries in 2020 vs. 2019 were similar for all age groups. During P3, there were more admissions with critical care in 2020 than in 2019 for the 2- to 5-year-olds (HRR, 1.17; 95%CI, 1.02-1.34; p = 0.025) and for 6- to 12-year-olds (HRR, 1.13; 95%CI, 1.00-1.28; p = 0.045). The number of admissions for trauma fell for all age groups, with the exception of infants below the age of one; in the latter age group, the number of admissions for thoracic, hip/thigh and head trauma increased in 2020 (by 21%, 8%, and 4%, respectively) ( eTable 3 ). The fall in admissions for traumatic head injury was most pronounced for 6- to 12-year-olds (by 46%) and teenagers (by 80%). Lastly, the reduction in admissions for drug intoxication and for poisoning by biological substances was particularly marked among 6- to 12-year-olds (44%) and teenagers (66%). DISCUSSION To the best of our knowledge, the present, large, nationwide study of an exhaustive hospital discharge database is the first to have investigated the impact of France’s first nationwide COVID-19 lockdown period on hospital admissions of children for injuries. The absolute number of admissions for injuries was 44% lower in 2020 than in the same period in 2019. The lockdown period was associated with a decrease in the admissions for all age groups, and the number of injury–related paediatric hospital stays involving critical care for at least 1 daywas lower in 2020 than in 2019. There are discrepancies between the literature data from single-centre and multicentre studies of paediatric injuries during lockdown. In a study of 16 paediatric emergency departments (EDs) in Italy, the mean incidence of injuries was significantly higher in 2020 (17.9%) than in 2019 (5.6%) [9]. These findings were in line with those of earlier single-centre studies performed in EDs in Italy, and Turkey [3,10]; despite the overall drop in ED visits between 2019 and 2020, the proportion of injury-related visits increased from 14% to 20.9% [11]. In a retrospective, single-centre study of a level 1 trauma centre in Austria, Payr et al. found that (i) the percentage of paediatric fractures did not decrease during the lockdown period, and (ii) the proportion of paediatric patients with mild traumatic brain injuries increased significantly [12]. In a single-centre study in France, Claudet et al. also reported an increase in the proportion of ED admissions for injuries [5]. However, all of these studies also observed a drop in the total number of visits to paediatric EDs. The greater likelihood of injury among children during a period of lockdown might be explained not only by the greater proportion of time spent at home but probably also by the negative psychological effects of home containment on both children and parents/caregivers; this might have weakened the level of child supervision and increased the likelihood of traumatic accidents - particularly among young children [3,9]. However, other single-centre and multicentre studies have found a decrease in trauma-related ED visits of up to 60% [4,13-15]. Hence, the present study of nationwide data is the first to have shown a fall in injury-related hospital admissions of children during a lockdown period in France. We included all injury-related hospital admissions in France (i.e. direct ward admissions and admissions through the ED). The discrepancies in the results might also be due to interstudy differences in methodologies, inclusion criteria (all injuries or not), the degree of adherence to lockdown restrictions in each country, and the type of lockdown (e.g. whether or not outdoor activities were authorized, for example) [3]. We found that all age groups were affected by the fall in the number of injuries during the lockdown period. Furthermore, our findings are similar to those reported by Ferro et al. and Keay et al. [3,13]. The lower incidence of sports injuries among teenagers might result from more time spent at home and more restrictions on outdoor activities. As found in the present, the literature data show that injury–related hospital admission with critical care for at least 1 daywas less frequent in 2020 than in 2019. In a study of 37 German PICUs with an average of 1444 admissions per centre, Bruns et al. observed that the number of admissions due to accidents/injuries fell from an average of 366 per centre to 346 per centre. Whereas the mean number of admissions for trauma rose from 196 to 212, the numbers of admissions traffic for accidents and school accidents decreased, whereas the numbers of household and leisure accidents increased [16]. The present study did not include data on where the injury or trauma had occurred. Payr et al.’s study of a trauma centre in Vienna evidenced a highly significant, proportional increase in paediatric patients with mild traumatic brain injuries [12]. However, the decrease in number of mild traumatic brain injuries in children aged 6 to 17 observed by Keays et al. was unprecedented over the past 28 years [13]. Moreover, Bruns et al. found a reduction in the incidence of neurosurgery for patients hospitalized in a PICU; this was probably due to a reduction in the number of severe traumatic brain injuries - as also observed in our study [16]. With regard to the types of injury, there were fewer admissions for trauma during P2 in 2020 than in 2019. This finding was expected because fractures in children are primarily due to falls during recreational and sports activities [3,17]. Likewise, the numbers of admissions for foreign body ingestion and poisoning were lower during P2 in 2020, relative to 2019. In a study of 27 children’s hospitals in the USA, Delaroche et al. reported a 45.7% decrease in paediatric ED visits and a 33.1% decrease in injury- and poisoning-related visits during the pandemic period, compared with the preceding 2 years [4]. Similar results were found in other studies [18,19]. In contrast, the results of Zhang et al.’s study in Canada showed significant relative and absolute increases in the numbers of unintentional, recreational, and intentional drug exposures recorded in the ED during the pandemic, compared with pre-pandemic years [20]. The greatest increases were seen among teenagers and among children below the age of 5. Among teenagers, intentional self-harm and recreational drug use (cannabis, vaping, and other recreational drugs) were the main causes of poisoning. In contrast to France, however, cannabis was legalized in Canada in 2018, e-cigarettes containing nicotine became legal in 2018, and cannabis extracts (including vaping products) became legal for sale on October 17 th , 2019. The results of Chang et al.’s study were consistent with literature data from the USA on a significant rise in exposure to cleaning products and disinfectants among children [21,22]. However, it was not clear whether the increase in calls to the poison control centre represented excessive concern and notifications by parents (who were at home more during the pandemic) or a true increase in exposure. Our study did not include data on calls to poison control centres in France. However, a fall in drug use by teenagers might be explained by a relative lack of access to drugs during the lockdown. Strengths and limitations The present population-based study had a number of strengths. Firstly, our inclusion of data from a large number of patients increased the study’s statistical power. Secondly, the use of well-characterized ICD-10 diagnostic codes (as used in previous studies of this topic) enabled the patients’ injuries to be properly categorized [1]. The study also had some limitations. Firstly, we did not have no data on where (indoors or outdoors) the injuries occurred. Secondly, the type of drugs involved in admissions for ingestion and poisoning was not documented. Lastly, the study’s retrospective design meant that the admission criteria applied at the various centres’ PICU could not be standardized. However, it should be noted that the French healthcare system did not collapse during the first wave of the pandemic, and no triage was performed for acute cases and emergencies. CONCLUSIONS Based on data from a nationwide cohort, the results of the present study suggest that France’s period of COVID-19 lockdown was associated with a decrease in the number of hospital admissions for paediatric injuries. Further research could usefully examine how parents create a safe home environment for their children and might then serve as the basis for a parent education program – even outside periods of lockdown. Abbreviations COVID-19 coronavirus disease 2019 PMSI Programme de Medicalisation des Systèmes d’Information ICD-10 Classification of Diseases and Related Health Problems, Tenth Revision PICU paediatric intensive care unit SD standard deviation HRR hospital admission rate ratio ED emergency departments SMR standardized morbidity ratio Declarations Conflict of Interest Disclosures (includes financial disclosures): The authors have no conflicts of interest to disclose. Funding/Support: No funding was secured for this study. Author Contributions: M. R., L. L., and S. L. conceptualized and designed the study, drafted the initial manuscript, and critically reviewed and revised the manuscript. A. B. and S. F. K. F. designed the data collection instruments, collected data, carried out the initial analyses, and critically reviewed and revised the manuscript. M. L-B. critically reviewed and revised the manuscript. D. T. conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Ethics approval: The University of Lille institutional review board waived the need for informed consent because the study used de-identified medical data and did not involve human participant research. The study was reported in line with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. References Lacarra B, Guyet-Job S, Pédrono G et al (2017) Home and recreational injuries in children under 1year: 10years of experience. Arch Pediatr 24:703–711 CoViD-19, containment and accidents in children's domestic life. Bull Acad Natl Med (2020) ;204(9):e30 Ferro V, Nacca R, Pisani M et al (2022) Children at risk of domestic accidents when are locked up at home: the other side of COVID-19 outbreak lockdown. Ital J Pediatr 48(1):129 DeLaroche AM, Rodean J, Aronson PL et al (2021) Paediatric Emergency Department Visits at US Children's Hospitals During the COVID-19 Pandemic. Paediatrics 147(4):e2020039628 Claudet I, Marchand-Tonel C, Ricco L, Houzé-Cerfon CH, Lang T, Bréhin C (2020) During the COVID-19 Quarantine, Home Has Been More Harmful Than the Virus for Children! Pediatr Emerg Care 36(9):e538–e540 De Jorna C, Liber M, Khalifi SE, Neggia G, Martinot A, Dubos F (2022) Changes in paediatric emergency department visits during a COVID-19 lockdown period: An exhaustive single-centre analysis. Arch Pediatr 29(8):604–609 Boudemaghe T, Belhadj I (2017) Int J Epidemiol 46(2):392–392dData Resource Profile: The French National Uniform Hospital Discharge Data Set Database (PMSI) R Core Team (2013) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL http://www.R-project.org/ Bezzini D, Lanari M, Amaddeo A et al (2023) Frequency and type of domestic injuries among children during COVID-19 lockdown: what changes from the past? An Italian multicentre cohort study. Eur J Pediatr 182(8):3445–3454. Erratum in: Eur J Pediatr 182(8):3455–3456 Bressan S, Gallo E, Tirelli F, Gregori D, Da Dalt L (2021) Lockdown: more domestic accidents than COVID-19 in children. Arch Dis Child 106(2):e3 Aydın O, Hanalıoğlu D, Ünal B et al (2022) What Has Changed in Injury-Related Presentations During COVID-19 Pandemic? A Single-Centre Experience from a Paediatric Emergency Department. Turk Arch Pediatr 57(4):453–458 Payr S, Schuller A, Dangl T et al (2021) Maintaining Medical Resources to Treat Paediatric Injuries during COVID-19 Lockdown Is Essential-An Epidemiological Analysis of a Level 1 Trauma Centre in Central Europe. Int J Environ Res Public Health 18(11):5829 Keays G, Friedman D, Gagnon I (2020) Injuries in the time of COVID-19. Health Promot Chronic Dis Prev Can 40(11–12):336–341 Hamill JK, Sawyer MC (2020) Reduction of childhood trauma during the COVID-19 Level 4 lockdown in New Zealand. ANZ J Surg 90(7–8):1242–1243 Nabian MH, Vosoughi F, Najafi F et al (2020) Epidemiological pattern of paediatric trauma in COVID-19 outbreak: Data from a tertiary trauma centre in Iran. Injury 51(12):2811–2815 Bruns N, Willemsen LY, Holtkamp K et al (2022) Impact of the First COVID Lockdown on Accident- and Injury-Related Paediatric Intensive Care Admissions in Germany-A Multicentre Study. Child (Basel) 9(3):363 Bolzinger M, Lopin G, Accadbled F, Sales de Gauzy J, Compagnon R (2023) Paediatric traumatology in green zone during Covid-19 lockdown: A single-centre study. Orthop Traumatol Surg Res 109(1):102946 Heppner Z, Shreffler J, Polites A, Ross A, Thomas JJ, Huecker M (2021) COVID-19 and emergency department volume: The patients return but have different characteristics. Am J Emerg Med 45:385–388 Sokoloff WC, Krief WI, Giusto KA et al (2021) Paediatric emergency department utilization during the COVID-19 pandemic in New York City. Am J Emerg Med 45:100–104 Zhang EWJ, Davis A, Finkelstein Y, Rosenfield D (2022) The effects of COVID-19 on poisonings in the paediatric emergency department. Paediatr Child Health 27(Suppl 1):S4–S8 Chang A, Schnall AH, Law R et al (2020) Cleaning and Disinfectant Chemical Exposures and Temporal Associations with COVID-19 - National Poison Data System, United States, January 1, 2020-March 31, 2020. MMWR Morb Mortal Wkly Rep 69(16):496–498 Levine M, Minns A, Ontiveros S, Thomas SH, Cantrell FL (2021) Evaluating the impact of home quarantine during the coronavirus pandemic on paediatric exploratory ingestions. Clin Toxicol (Phila) 59(7):673–674 Additional Declarations No competing interests reported. Supplementary Files eTable1.docx eTable2.docx eTable3.docx Cite Share Download PDF Status: Published Journal Publication published 04 Dec, 2024 Read the published version in European Journal of Pediatrics → Version 1 posted Editorial decision: Revision requested 28 Aug, 2024 Reviews received at journal 25 Aug, 2024 Reviews received at journal 24 Aug, 2024 Reviews received at journal 29 Jul, 2024 Reviewers agreed at journal 29 Jul, 2024 Reviewers agreed at journal 27 Jul, 2024 Reviewers agreed at journal 25 Jul, 2024 Reviewers invited by journal 24 Jul, 2024 Editor assigned by journal 23 Jul, 2024 Submission checks completed at journal 23 Jul, 2024 First submitted to journal 18 Jul, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Lille, CHU Lille, METRICS : Évaluation des technologies de santé et des pratiques médicales","correspondingAuthor":false,"prefix":"","firstName":"Amélie","middleName":"","lastName":"Bruandet","suffix":""}],"badges":[],"createdAt":"2024-07-18 12:09:02","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4762515/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4762515/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s00431-024-05900-0","type":"published","date":"2024-12-04T15:57:41+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":63290271,"identity":"5a481e2e-76fd-4e73-8cfc-80933e174500","added_by":"auto","created_at":"2024-08-26 14:11:07","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":142644,"visible":true,"origin":"","legend":"\u003cp\u003eStudy flow chart. Consecutive hospital stays for which the time interval between stays was less than 1 day were considered to be a single stay. DRG: diagnosis-related group.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4762515/v1/e2eac185655112d7974a4b3b.jpg"},{"id":63290929,"identity":"15c23526-1221-47ea-8390-e34956229320","added_by":"auto","created_at":"2024-08-26 14:19:07","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":187373,"visible":true,"origin":"","legend":"\u003cp\u003eHospital admission rate ratios (HRR) for paediatric injuries by age and by sex, from January 1\u003csup\u003est\u003c/sup\u003e to July 31\u003csup\u003est\u003c/sup\u003e, 2019, and from January 1\u003csup\u003est\u003c/sup\u003e to July 31\u003csup\u003est\u003c/sup\u003e, 2020.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4762515/v1/f0fc200b2eb32fdbca6d5e41.jpg"},{"id":63289212,"identity":"2429cc7a-9196-4064-b9db-187ce6b5bc2c","added_by":"auto","created_at":"2024-08-26 14:03:07","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":187227,"visible":true,"origin":"","legend":"\u003cp\u003eHospital admission rate ratios (HRR) for paediatric injuries requiring critical care by age and by sex, from January 1\u003csup\u003est\u003c/sup\u003e to July 31\u003csup\u003est\u003c/sup\u003e, 2019, and from January 1\u003csup\u003est\u003c/sup\u003e to July 31\u003csup\u003est\u003c/sup\u003e, 2020.\u003c/p\u003e","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4762515/v1/ec5b52dba0fd4481fc1428a5.jpg"},{"id":70964807,"identity":"02d3563e-80cc-43bb-88b4-2d066f1c586c","added_by":"auto","created_at":"2024-12-09 16:16:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1338066,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4762515/v1/75ef72a3-8c16-45b0-a7a1-276b2d8636ec.pdf"},{"id":63290270,"identity":"c373704b-5b2d-411e-9ffa-cf6553307172","added_by":"auto","created_at":"2024-08-26 14:11:07","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":13290,"visible":true,"origin":"","legend":"","description":"","filename":"eTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-4762515/v1/3f7fc4e3dcce89a95e3bb96a.docx"},{"id":63289211,"identity":"07d97c7c-8d90-4e2d-b509-69200e110953","added_by":"auto","created_at":"2024-08-26 14:03:07","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":14888,"visible":true,"origin":"","legend":"","description":"","filename":"eTable2.docx","url":"https://assets-eu.researchsquare.com/files/rs-4762515/v1/a1a280d306d8a6e52866b935.docx"},{"id":63289213,"identity":"06e82fb9-a6c8-438b-8cc9-a21111530891","added_by":"auto","created_at":"2024-08-26 14:03:07","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":16107,"visible":true,"origin":"","legend":"","description":"","filename":"eTable3.docx","url":"https://assets-eu.researchsquare.com/files/rs-4762515/v1/44d0bde12e3302d6ba79ea6b.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Impact of the COVID-19 lockdown period on hospital admissions for pediatric injuries: a French nationwide study","fulltext":[{"header":"What is Known ","content":"\u003cp\u003eDuring the COVID-19 pandemic, lockdown posed a number of unprecedented problems.\u0026nbsp;Injuries to children\u0026nbsp;are a major public health concern.\u0026nbsp;This study sought to determine the impact of France’s 2020 COVID-19 lockdown on\u0026nbsp;hospital admissions for pediatric injuries.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWhat is New\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe first nationwide COVID-19 lockdown in France was associated with a decrease in the absolute number of hospital admissions for pediatric injuries, for all age groups, as well as the number of injury–related pediatric hospital stays involving critical care.\u003c/p\u003e"},{"header":"INTRODUCTION","content":"\u003cp\u003eThe coronavirus disease 2019 (COVID-19) pandemic was an international public health emergency. Guided by the World Health Organization, many countries implemented periods of \u0026ldquo;lockdown\u0026rdquo; to control the spread of the disease. In France, the first period of strict lockdown ran from March 16th to May 10th, 2020. Following the introduction of emergency legislation, people were confined to their homes, and outdoor movement was restricted to essential activities (including medical care).\u003c/p\u003e \u003cp\u003eMost accidents involving children or injuries to children occur (i) during domestic accidents (include poisoning, burns, suffocation by foreign bodies, falls, and drowning) at home or in the immediate surroundings (the garden, yard, or garage), (ii) away from the home (e.g. at school or during sports activities); and (iii) on vacation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The French Academy of Medicine has reported that since the implementation of COVID-19 containment measures, the emergency services, firefighters and media have reported an increase in domestic accidents [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, the literature data on the number of children attending hospital for an injury during the lockdown period are contradictory, with both increases and decreases reported [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Moreover, all the studies of this topic in France were conducted at single centres, and nationwide data are lacking [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn view of these gaps in our knowledge, we decided to perform a large, nationwide, population-based cohort study. We hypothesized that the number of injury\u0026ndash;related hospital admissions among children and teenagers would decrease during France\u0026rsquo;s first period of nationwide COVID-19 lockdown, as a results of changes in social behaviour and mobility. The primary objective was to describe the impact of France\u0026rsquo;s first period of COVID-19 lockdown on the number of injury-related hospital admissions of children. The secondary objectives were to perform stratified analyses by age group.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData source\u003c/h2\u003e \u003cp\u003eIn the present retrospective cohort study, we analysed data extracted from the French national inpatient database (\u003cem\u003eProgramme de Medicalisation des Syst\u0026egrave;mes d\u0026rsquo;Information\u003c/em\u003e (PMSI)) [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The PMSI is populated with information on diagnoses and medical procedures from standardized hospital discharge reports. The coding and reporting of this information is mandatory in all hospital departments. The discharge report abstracts in the PMSI include the patients\u0026rsquo; demographic characteristics, diagnostic codes (based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10]), and medical procedure codes (based on the French \u003cem\u003eClassification Commune des Actes M\u0026eacute;dicaux\u003c/em\u003e).\u003c/p\u003e \u003cp\u003eTo ensure that the data are of high quality, routine tests are performed when information on inpatient stays is sent to the French public health insurance agency. These tests include checks on the chronology of the hospital stays, the format of the demographic characteristics (missing, incorrect or inaccurate values for the sex, age, date, mode of entry, and date and mode of discharge), the format and accuracy of procedure and diagnostic codes, and the coherence of the relationships between procedure codes, diagnostic codes, the length of hospital stay, age, and sex.\u003c/p\u003e \u003cp\u003eThe University of Lille institutional review board waived the need for informed consent because the study used de-identified medical data and did not involve human participant research. The study was reported in line with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThe study included paediatric patients (from 1 day to 17 years of age) admitted to hospital for injuries (including domestic accidents like trauma, intoxication, poisoning, and drowning) in metropolitan France from January 1st to July 31st, 2019 (the control period) and from January 1st to July 31st, 2020 (the study period). The diagnostic codes are given in \u003cb\u003eeTable 1\u003c/b\u003e. The four age subgroups studied were below 1 year of age, 2 to 5, 6 to 12, and 13 to 17.\u003c/p\u003e \u003cp\u003eThe exclusion criteria were an incorrect patient identifier, an incorrect French diagnosis-related group, and death less than 1 day after delivery. Consecutive hospital stays for which the time interval between stays was less than 1 day were considered to be a single stay. The start of the care sequence was defined as the starting date of the first stay, and the end date was defined as the date of death or the date of discharge at the end of the last stay.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eExposures of Interest\u003c/h2\u003e \u003cp\u003eThe main exposure of interest was the year 2020 vs. the year 2019. For the two years, three periods (Ps) were considered: January 1st to March 15th (before the lockdown, referred to hereafter as P1), March 16th to May 10th (during the lockdown, P2), and May 11th to July 31st (after the lockdown, P3). The patient\u0026rsquo;s sex, age, and hospital status were reported, together with whether the patient had died during the hospital stay. Critical care was defined as admission to a paediatric intensive care unit (PICU) or a paediatric intermediate care unit. During a given hospital stay, a patient could be admitted to both a PICU and a paediatric intermediate care unit.\u003c/p\u003e \u003cp\u003eThe primary outcome was the number of injury\u0026ndash;related hospital stays lasting 1 day or more for children in France from March 16th to May 10th, 2020. The secondary outcome was the number of these admissions involving critical care.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eCategorical variables were expressed as the frequency (percentage), and continuous variables were expressed as the mean (standard deviation (SD)). The hospital admission rate ratio (HRR) for the study period vs. the control period was calculated for P1, P2 and P3, i.e. before lockdown, during lockdown, and after lockdown, respectively. The secondary outcomes were the changes in HRRs stratified by age group. For each interval and each modality of the secondary outcome variables, HRRs comparing the study period with the control period were calculated by using Poisson regression to model the overall number of hospital admissions. All tests were two-tailed, and the threshold for statistical significance was set to P\u0026thinsp;\u0026lt;\u0026thinsp;.05. All statistical analyses were performed using R software (version 4.3.0) [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eCharacteristics of patients admitted for injuries from January to July in 2020 vs. 2019\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn France, a total of 166126\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ehospital stays for paediatric injuries were recorded from January 1\u003csup\u003est\u003c/sup\u003e to July 31\u003csup\u003est\u003c/sup\u003e, 2019, and from January 1\u003csup\u003est\u003c/sup\u003e to July 31\u003csup\u003est\u003c/sup\u003e, 2020 (\u003cstrong\u003eTable 1\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e. Characteristics of Patients with Paediatric Injuries Before, During, and After the First Period of COVID-19 Lockdown in France.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1030\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.223300970873787%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.9126213592233%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.067961165048544%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore lockdown (P1)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.9126213592233%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuring lockdown (P2)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.883495145631066%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter lockdown (P3)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eAll (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e84 961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e72089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\" valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e26268\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e25584\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e23098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e12864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e35595\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e33641\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eAge (year)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.3230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e9.2 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e8.7 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e9.5 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e9.6 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e9.3 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e7.2 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e9.0 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e8.7 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eRange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e10.0 (4.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e9.0 (3.0-14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e11.0 (4.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e11.0 (4.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e10.0 (4.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e6.0 (2.0-12.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e10.0 (4.0-14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e9.0 (3.0-14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eAge categories n (%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.1818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eBelow 1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e12073 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e11682 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e3894 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e3813 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e3151 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e2532 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e5028 (14.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e5337 (15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e2-5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e14950 (17.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e13852 (19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e4275 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e3991 (15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e4152 (18.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e3351 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e6524 (18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e6509 (19.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e6-12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e25183 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e21221 (29.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e7092 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e6906 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e6895 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e3941 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e11196 (31.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e10374 (30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e13-17 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e32754 (38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e25335 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e11007 (41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e10874 (42.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e8900 (38.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e3040 (23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e12847 (36.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e11421 (33.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eSex n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e0.9866\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.1655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.3153\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eGirl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e33984 (40.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e28833 (40.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e10999 (41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e10559 (41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e9285 (40.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e5449 (42.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e13701 (38.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e12824 (38.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eBoy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e50976 (60.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e43257 (60.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e15269 (58.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e15025 (58.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e13813 (59.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e7415 (57.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e21894 (61.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e20817 (61.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eLength of hospital stay\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.2957\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1.6 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1.6 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1.8 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1.7 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1.6 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e1.7 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1.5 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e1.5 (4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eRange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e0.0-203.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e0.0-293.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e0.0-151.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e0.0-277.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e0.0-293.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0-227.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e0.0-173.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e0.0-193.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1.0 (0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1.0 (0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1.0 (0.0-2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1.0 (0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1.0 (0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e1.0 (0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1.0 (0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e1.0 (0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eLength of hospital stay (days in classes) (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.0002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e\u0026lt; 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e32781 (38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e28306 (39.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e10199 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e10405 (40.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e8922 (38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e4924 (38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e13660 (38.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e12977 (38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e1 \u0026lt;2\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e32106 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e27598 (38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e9381 (35.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e8969 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e8722 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e5107 (39.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e14003 (39.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e13522 (40.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e2 \u0026lt;3 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e8540 (10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e6998 (9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e2587 (9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e2448 (9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e2257 (9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e1219 (9.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e3696 (10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e3331 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003e\u0026ge;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e11533 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e9188 (12.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e4101 (15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e3762 (14.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e3197 (13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e1614 (12.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e4236 (11.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e3811 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eDeath in hospital n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e0.2370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.8576\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.3035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0199\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e84797 (99.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e71970 (99.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e26219 (99.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e25538 (99.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e23059 (99.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e12836 (99.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e35520 (99.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e33595 (99.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e163 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e120 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e49 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e46 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e39 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e28 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e75 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e46 (0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eAdmissions with critical care n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.9654\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0021\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e79190 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e66796 (92.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e24484 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e23844 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e21546 (93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e11815 (91.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e33160 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e31137 (92.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e5770 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e5294 (7.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1784 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1740 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1552 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e1049 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e2435 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e2504 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eAdmissions to a PICU n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e0.0757\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.2721\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.0099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0618\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e82955 (97.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e70289 (97.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e25631 (97.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e25001 (97.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e22569 (97.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e12513 (97.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e34756 (97.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e32774 (97.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e2005 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1801 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e637 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e583 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e529 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e351 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e839 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e867 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eAdmissions to a paediatric intermediate care unit n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.7190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e80819 (95.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e68222 (94.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e24981 (95.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e24313 (95.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e21980 (95.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e12092 (94.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e33858 (95.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e31817 (94.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e4141 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e3868 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1287 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e1271 (5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1118 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e772 (6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e1737 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e1824 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\" valign=\"bottom\"\u003e\n \u003cp\u003eSurgery n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e0.4051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.0243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e0.5774\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e0.0006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e42625 (50.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e36320 (50.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e13795 (52.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e13183 (51.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e11618 (50.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e6431 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e17212 (48.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e16706 (49.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.205426356589147%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e42335 (49.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e35770 (49.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e12473 (47.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.236434108527131%\"\u003e\n \u003cp\u003e12401 (48.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e11480 (49.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e6433 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.523255813953488%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.364341085271318%\"\u003e\n \u003cp\u003e18383 (51.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.395348837209302%\"\u003e\n \u003cp\u003e16935 (50.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.077519379844961%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: SD, standard deviation; IQR: interquartile range; PICU: paediatric intensive care unit.\u003c/p\u003e\n\u003cp\u003eAfter the exclusion of stays that did not meet the study\u0026rsquo;s criteria, 157050 hospital stays were included in our analysis (\u003cstrong\u003eFigure 1\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003eIn 2020, 72089 hospital stays for injuries were recorded (mean (SD) patient age, 8.7 (5.8) years; females: 40%), and the mean (SD) length of stay was 1.6 (4.6) days). In 2019, 84961 hospital stays for injuries were recorded (mean (SD) age, 9.2 (5.7) years; females: 40%), with a mean (SD) length of stay was 1.6 (4.3) days.\u003c/p\u003e\n\u003cp\u003eThe number of hospitals stays for injuries was 12864 for P2 in 2020 (mean (SD) patient age: 7.2 (5.5) years) and 23098 for P2 in 2019 (mean (SD) patient age: 9.3 (5.7) years; HRR, 0.56; 95%CI, 0.55-0.57; p\u0026nbsp;\u0026lt; .001) (\u003cstrong\u003eFigure 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe number of traumatic head injuries fell by 45%. The number of traumatic ankle and foot injuries fell by between 29%, the number of traumatic neck injuries fell by 70%, and the number of drug poisoning and toxic events decreased by between 30% and 50% (\u003cstrong\u003eeTable 2\u003c/strong\u003e). During P2, the mortality rates were low and similar in 2020 and 2019 (0.2%), and the year-on-year difference in the incidence of surgery (50% in 2020 vs. 49.7% in 2019) was not significant.\u003c/p\u003e\n\u003cp\u003eFor P1 and P3, there were significantly fewer admissions for injuries in 2020 than in 2019; the HRR was 0.97 (95%CI, 0.96-0.99; p\u0026nbsp;= .003) for P1 and 0.95 (95%CI, 0.93-0.96; p\u0026nbsp;\u0026lt; .001) for P3 (\u003cstrong\u003eFigure 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInjury\u0026ndash;related hospital stays with critical care lasting \u0026ge; 1 day from January to July in 2020 vs. 2019\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 4874 paediatric admissions with at least one stay in a critical care unit were recorded in 2020 (1606 in P1, 958 in P2, and 2310 in P3), and 5302 were recorded in 2019 (1632 in P1, 1430 in P2, and 2240 in P3) (\u003cstrong\u003eTable 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e. Characteristics of Paediatric Patients Admitted to a Critical Care Unit for At Least 1 Day Before, During, and After the First Period of COVID-19 Lockdown in France.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"989\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.234817813765183%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.781376518218625%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore lockdown (P1)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.125506072874494%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuring lockdown (P2)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.858299595141702%\" colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter lockdown (P3)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eAll (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e1 632\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1606\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e958\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e2240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e2310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eAge (year)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.6621\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.0057\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e8.7 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e8.8 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e8.8 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e6.8 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e8.8 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e8.3 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eRange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e0.0-17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e10.0 (1.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e10.0 (2.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e10.0 (2.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e5.0 (1.0-13.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e10.0 (2.0-15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e8.0 (2.0-14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eAge categories n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.2583\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e\u0026lt;.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.0008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eBelow 1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e421 (25.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e386 (24.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e296 (20.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e298 (31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e467 (20.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e515 (22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e2-5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e218 (13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e241 (15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e250 (17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e206 (21.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e377 (16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e441 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e6-12 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e314 (19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e285 (17.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e307 (21.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e183 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e475 (21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e539 (23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e13-17 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e679 (41.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e694 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e577 (40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e271 (28.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e921 (41.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e815 (35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eSex n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.2877\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e0.0693\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.1733\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e760 (46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e718 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e603 (42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e440 (45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e918 (41.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e901 (39.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e872 (53.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e888 (55.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e827 (57.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e518 (54.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e1322 (59.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e1409 (61.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eLength of hospital stay n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.4506\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e0.3496\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.0380\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e7.4 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e8.0 (14.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e7.4 (13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e7.5 (14.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e6.4 (12.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e6.6 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eRange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e1.0-146.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1.0-277.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1.0-293.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e1.0-227.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e1.0-173.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e1.0-193.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e3.0 (1.0-8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e3.0 (1.0-9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e3.0 (1.0-8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e3.0 (1.0-9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e3.0 (1.0-7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e3.0 (1.0-7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eLength of hospital stay (days, in classes) n, (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.8608\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e0.0930\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.0559\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e1-\u0026lt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e471 (28.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e460 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e389 (27.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e298 (31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e731 (32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e722 (31.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e2-\u0026lt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e231 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e218 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e217 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e147 (15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e377 (16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e344 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e\u0026ge;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e930 (57.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e928 (57.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e824 (57.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e513 (53.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e1 132 (50.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e1 244 (53.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eDeath in hospital n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.2620\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e0.0589\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.3843\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e1607 (98.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1573 (97.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1415 (99.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e939 (98.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e2204 (98.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e2280 (98.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e25 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e33 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e15 (1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e19 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e36 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e30 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eAdmissions to a PICU n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.2243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e0.5578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.3558\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e1047 (64.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1063 (66.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e951 (66.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e626 (65.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e1476 (65.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e1492 (64.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e585 (35.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e543 (33.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e479 (33.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e332 (34.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e764 (34.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e818 (35.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eAdmissions to a paediatric intermediate care unit n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.7168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e0.7952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.5963\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e437 (26.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e421 (26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e377 (26.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e248 (25.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e611 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e614 (26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e1195 (73.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1185 (73.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1053 (73.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e710 (74.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e1629 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e1696 (73.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\" valign=\"bottom\"\u003e\n \u003cp\u003eSurgery n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e0.3037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e0.5507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e0.0922\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e1133 (69.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1088 (67.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e1006 (70.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e663 (69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e1557 (69.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e1552 (67.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\"\u003e\n \u003cp\u003e499 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e518 (32.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.39231547017189%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.31344792719919%\"\u003e\n \u003cp\u003e424 (29.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.223458038422649%\"\u003e\n \u003cp\u003e295 (30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.6622851365015165%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.111223458038422%\"\u003e\n \u003cp\u003e683 (30.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.425682507583417%\"\u003e\n \u003cp\u003e758 (32.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.291203235591507%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: SD, standard deviation; IQR: interquartile range; PICU: paediatric intensive care unit.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFor P2, the risk of an injury\u0026ndash;related\u0026nbsp;hospital stays with critical care lasting for at least 1 day\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ewas lower in 2020\u0026nbsp;than in 2019 (HRR\u0026nbsp;0.67; 95%CI, 0.62-0.73; p\u0026nbsp;\u0026lt; .001) (\u003cstrong\u003eFigure 3\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe mean (SD) patient age was 6.8 (6.2) in 2020 and 8.8 (6.3) in 2019 (p \u0026lt; .001). The mean (SD) length of stay with critical care was (7.5 (14.1) days in 2020 and 7.4 (13.9) days in 2019; this difference was not significant (p = 0.35). Likewise, the year-on-year difference in the proportion of patients having undergone surgery during P2 was not significant (30.8% in 2020 vs. 29.7% in 2019; p = 0.55).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFor P1 and P3, the numbers of paediatric admissions with at least one stay in a critical care unit were similar in 2020 and 2019 (\u003cstrong\u003eFigure 3\u003c/strong\u003e). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStratified analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhen the absolute number of injuries was stratified by age, the lockdown period comprised fewer admissions in 2020 than in 2019 for all age groups (\u003cstrong\u003eTables 1 and 2, and Figure 2\u003c/strong\u003e). The largest decreases were observed for teenagers (aged 13-17; HRR, 0.34; 95%CI, 0.33-0.36; p\u0026nbsp;\u0026lt; .001) and for 6- to 12-year-olds (HRR, 0.57; 95%CI, 0.55-0.59; p\u0026nbsp;\u0026lt; .001). During P1, the number of admissions was similar in 2020 and 2019 for all age groups other than the 2-to 5-year-olds (HRR, 0.93; 95%CI, 0.89-0.97; p\u0026nbsp;= 0.002). During P3, there were more admissions in 2020 than in 2019 for the youngest children (below 1 year of age; HRR, 1.06; 95%CI, 1.02-1.10; p\u0026nbsp;= 0.002) and fewer admissions for 6- to 12-year-olds (HRR, 0.93; 95%CI, 0.90-0.95; p \u0026lt; .0001) and teenagers (HRR, 0.89; 95%CI, 0.87-0.91; p \u0026lt; .0001).\u003c/p\u003e\n\u003cp\u003eWe next\u0026nbsp;stratified the data for injury\u0026ndash;related hospital stays involving at least 1 day of critical care by age group (\u003cstrong\u003eFigure 3\u003c/strong\u003e): the most significant fall from 2020 to 2019 during P2 was again observed for teenagers (HRR, 0.47; 95%CI, 0.41-0.54; p\u0026nbsp;\u0026lt; .001) and 6- to 12-year-olds (HRR, 0.60; 95%CI, 0.50-0.71; p\u0026nbsp;\u0026lt; .001). During P1, the numbers of injuries in 2020 vs. 2019 were similar for all age groups. During P3, there were more admissions with critical care in 2020 than in 2019 for the 2- to 5-year-olds (HRR, 1.17; 95%CI, 1.02-1.34; p\u0026nbsp;= 0.025) and for 6- to 12-year-olds (HRR, 1.13; 95%CI, 1.00-1.28; p\u0026nbsp;= 0.045).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe number of admissions for trauma fell for all age groups, with the exception of infants below the age of one; in the latter age group, the number of admissions for thoracic, hip/thigh and head trauma increased in 2020 (by 21%, 8%, and 4%, respectively) (\u003cstrong\u003eeTable 3\u003c/strong\u003e). The fall in admissions for traumatic head injury was most pronounced for 6- to 12-year-olds (by 46%) and teenagers (by 80%). Lastly, the reduction in admissions for drug intoxication and for poisoning by biological substances was particularly marked among 6- to 12-year-olds (44%) and teenagers (66%).\u0026nbsp;\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eTo the best of our knowledge, the present, large, nationwide study of an exhaustive hospital discharge database is the first to have investigated the impact of France’s first nationwide COVID-19 lockdown period on hospital admissions of children for injuries. The absolute number of admissions for injuries was 44% lower in\u0026nbsp;2020 than in the same period in 2019. The lockdown period was associated with a decrease in the admissions for all age groups, and the number of injury–related paediatric hospital stays involving\u0026nbsp;critical care for at least 1 daywas lower in 2020\u0026nbsp;than in 2019.\u003c/p\u003e\n\u003cp\u003eThere are discrepancies between the literature data from single-centre and multicentre studies of paediatric injuries during lockdown. In a study of 16 paediatric emergency departments (EDs) in Italy, the mean incidence of injuries was significantly higher in 2020 (17.9%) than in 2019 (5.6%) [9]. These findings were in line with those of earlier single-centre studies performed in EDs in Italy, and Turkey [3,10]; despite the overall drop in ED visits between 2019 and 2020, the proportion of injury-related visits increased from 14% to 20.9% [11]. In a retrospective, single-centre study of a level 1 trauma centre in Austria, Payr et al. found that (i) the percentage of paediatric fractures did not decrease during the lockdown period, and (ii) the proportion of paediatric patients with mild traumatic brain injuries increased significantly [12]. In a single-centre study in France, Claudet et al. also reported an increase in the proportion of ED admissions for injuries [5]. However, all of these studies also observed a drop in the total number of visits to paediatric EDs. The greater likelihood of injury among children during a period of lockdown might be explained not only by the greater proportion of time spent at home but probably also by the negative psychological effects of home containment on both children and parents/caregivers; this might have weakened the level of child supervision and increased the likelihood of traumatic accidents - particularly among young children [3,9]. However, other single-centre and multicentre studies have found a decrease in trauma-related ED visits of up to 60% [4,13-15]. Hence, the present study of nationwide data is the first to have shown a fall in injury-related hospital admissions of children during a lockdown period in France. We included all injury-related hospital admissions in France (i.e. direct ward admissions and admissions through the ED). The discrepancies in the results might also be due to interstudy differences in methodologies, inclusion criteria (all injuries or not), the degree of adherence to lockdown restrictions in each country, and the type of lockdown (e.g. whether or not outdoor activities were authorized, for example) [3]. We found that all age groups were affected by the fall in the number of injuries during the lockdown period. Furthermore, our findings are similar to those reported by Ferro et al. and Keay et al. [3,13]. The lower incidence of sports injuries among teenagers might result from more time spent at home and more restrictions on outdoor activities.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs found in the present, the literature data show that injury–related hospital admission with critical care for at least 1 daywas less frequent in 2020 than in 2019. In a study of 37 German PICUs with an average of 1444 admissions per centre, Bruns et al. observed that the number of admissions due to accidents/injuries fell from an average of 366 per centre to 346 per centre. Whereas the mean number of admissions for trauma rose from 196 to 212, the numbers of admissions traffic for accidents and school accidents decreased, whereas the numbers of household and leisure accidents increased [16]. The present study did not include data on where the injury or trauma had occurred. Payr et al.’s study of a trauma centre in Vienna evidenced a highly significant, proportional increase in paediatric patients with mild traumatic brain injuries [12]. However, the decrease in number of mild traumatic brain injuries in children aged 6 to 17 observed by Keays et al. was unprecedented over the past 28 years [13]. Moreover, Bruns et al. found a reduction in the incidence of neurosurgery for patients hospitalized in a PICU; this was probably due to a reduction in the number of severe traumatic brain injuries - as also observed in our study [16].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWith regard to the types of injury, there were fewer admissions for trauma during P2 in 2020 than in 2019. This finding was expected because fractures in children are primarily due to falls during recreational and sports activities [3,17]. Likewise, the numbers of admissions for foreign body ingestion and poisoning were lower during P2 in 2020, relative to 2019. In a study of 27 children’s hospitals in the USA, Delaroche et al. reported a 45.7% decrease in paediatric ED visits and a 33.1% decrease in injury- and poisoning-related visits during the pandemic period, compared with the preceding 2 years [4]. Similar results were found in other studies [18,19]. In contrast, the results of Zhang et al.’s study in Canada showed significant relative and absolute increases in the numbers of unintentional, recreational, and intentional drug exposures recorded in the ED during the pandemic, compared with pre-pandemic years [20]. The greatest increases were seen among teenagers and among children below the age of 5. Among teenagers, intentional self-harm and recreational drug use (cannabis, vaping, and other recreational drugs) were the main causes of poisoning. In contrast to France, however, cannabis was legalized in Canada in 2018, e-cigarettes containing nicotine became legal in 2018, and cannabis extracts (including vaping products) became legal for sale on October 17\u003csup\u003eth\u003c/sup\u003e, 2019. The results of Chang et al.’s study were consistent with literature data from the USA on a significant rise in exposure to cleaning products and disinfectants among children [21,22]. However, it was not clear whether the increase in calls to the poison control centre represented excessive concern and notifications by parents (who were at home more during the pandemic) or a true increase in exposure. Our study did not include data on calls to poison control centres in France. However, a fall in drug use by teenagers might be explained by a relative lack of access to drugs during the lockdown.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present population-based study had a number of strengths. Firstly, our inclusion of data from a large number of patients increased the study’s statistical power. Secondly, the use of well-characterized ICD-10 diagnostic codes (as used in previous studies of this topic) enabled the patients’\u0026nbsp;injuries\u0026nbsp;to be properly categorized [1].\u003c/p\u003e\n\u003cp\u003eThe study also had some limitations. Firstly, we did not have no data on where (indoors or outdoors) the injuries occurred. Secondly, the type of drugs involved in admissions for ingestion and poisoning was not documented. Lastly, the study’s retrospective design meant that the admission criteria applied at the various centres’ PICU could not be standardized. However, it should be noted that the French healthcare system did not collapse during the first wave of the pandemic, and no triage was performed for acute cases and emergencies.\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eBased on data from a nationwide cohort, the results of the present study suggest that France\u0026rsquo;s period of COVID-19 lockdown was associated with a decrease in the number of hospital admissions for paediatric injuries. Further research could usefully examine how parents create a safe home environment for their children and might then serve as the basis for a parent education program \u0026ndash; even outside periods of lockdown.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOVID-19\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ecoronavirus disease 2019\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePMSI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eProgramme de Medicalisation des Syst\u0026egrave;mes d\u0026rsquo;Information\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICD-10\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eClassification of Diseases and Related Health Problems, Tenth Revision\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePICU\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003epaediatric intensive care unit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003estandard deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHRR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehospital admission rate ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eED\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eemergency departments\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSMR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003estandardized morbidity ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest Disclosures (includes financial disclosures):\u003c/strong\u003e The authors have no conflicts of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding/Support:\u003c/strong\u003e No funding was secured for this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eM. R., L. L., and S. L. conceptualized and designed the study, drafted the initial manuscript, and critically reviewed and revised the manuscript. A. B. and S. F. K. F. designed the data collection instruments, collected data, carried out the initial analyses, and critically reviewed and revised the manuscript. M. L-B. critically reviewed and revised the manuscript. D. T. conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval:\u003c/strong\u003e The University of Lille institutional review board waived the need for informed consent because the study used de-identified medical data and did not involve human participant research. The study was reported in line with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLacarra B, Guyet-Job S, P\u0026eacute;drono G et al (2017) Home and recreational injuries in children under 1year: 10years of experience. Arch Pediatr 24:703\u0026ndash;711\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoViD-19, containment and accidents in children's domestic life. Bull Acad Natl Med (2020) ;204(9):e30\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFerro V, Nacca R, Pisani M et al (2022) Children at risk of domestic accidents when are locked up at home: the other side of COVID-19 outbreak lockdown. Ital J Pediatr 48(1):129\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDeLaroche AM, Rodean J, Aronson PL et al (2021) Paediatric Emergency Department Visits at US Children's Hospitals During the COVID-19 Pandemic. Paediatrics 147(4):e2020039628\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClaudet I, Marchand-Tonel C, Ricco L, Houz\u0026eacute;-Cerfon CH, Lang T, Br\u0026eacute;hin C (2020) During the COVID-19 Quarantine, Home Has Been More Harmful Than the Virus for Children! Pediatr Emerg Care 36(9):e538\u0026ndash;e540\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Jorna C, Liber M, Khalifi SE, Neggia G, Martinot A, Dubos F (2022) Changes in paediatric emergency department visits during a COVID-19 lockdown period: An exhaustive single-centre analysis. Arch Pediatr 29(8):604\u0026ndash;609\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoudemaghe T, Belhadj I (2017) Int J Epidemiol 46(2):392\u0026ndash;392dData Resource Profile: The French National Uniform Hospital Discharge Data Set Database (PMSI)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eR Core Team (2013) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.R-project.org/\u003c/span\u003e\u003cspan address=\"http://www.R-project.org/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBezzini D, Lanari M, Amaddeo A et al (2023) Frequency and type of domestic injuries among children during COVID-19 lockdown: what changes from the past? An Italian multicentre cohort study. Eur J Pediatr 182(8):3445\u0026ndash;3454. Erratum in: Eur J Pediatr 182(8):3455\u0026ndash;3456\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBressan S, Gallo E, Tirelli F, Gregori D, Da Dalt L (2021) Lockdown: more domestic accidents than COVID-19 in children. Arch Dis Child 106(2):e3\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAydın O, Hanalıoğlu D, \u0026Uuml;nal B et al (2022) What Has Changed in Injury-Related Presentations During COVID-19 Pandemic? A Single-Centre Experience from a Paediatric Emergency Department. Turk Arch Pediatr 57(4):453\u0026ndash;458\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePayr S, Schuller A, Dangl T et al (2021) Maintaining Medical Resources to Treat Paediatric Injuries during COVID-19 Lockdown Is Essential-An Epidemiological Analysis of a Level 1 Trauma Centre in Central Europe. Int J Environ Res Public Health 18(11):5829\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeays G, Friedman D, Gagnon I (2020) Injuries in the time of COVID-19. Health Promot Chronic Dis Prev Can 40(11\u0026ndash;12):336\u0026ndash;341\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHamill JK, Sawyer MC (2020) Reduction of childhood trauma during the COVID-19 Level 4 lockdown in New Zealand. ANZ J Surg 90(7\u0026ndash;8):1242\u0026ndash;1243\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNabian MH, Vosoughi F, Najafi F et al (2020) Epidemiological pattern of paediatric trauma in COVID-19 outbreak: Data from a tertiary trauma centre in Iran. Injury 51(12):2811\u0026ndash;2815\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBruns N, Willemsen LY, Holtkamp K et al (2022) Impact of the First COVID Lockdown on Accident- and Injury-Related Paediatric Intensive Care Admissions in Germany-A Multicentre Study. Child (Basel) 9(3):363\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBolzinger M, Lopin G, Accadbled F, Sales de Gauzy J, Compagnon R (2023) Paediatric traumatology in green zone during Covid-19 lockdown: A single-centre study. Orthop Traumatol Surg Res 109(1):102946\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeppner Z, Shreffler J, Polites A, Ross A, Thomas JJ, Huecker M (2021) COVID-19 and emergency department volume: The patients return but have different characteristics. Am J Emerg Med 45:385\u0026ndash;388\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSokoloff WC, Krief WI, Giusto KA et al (2021) Paediatric emergency department utilization during the COVID-19 pandemic in New York City. Am J Emerg Med 45:100\u0026ndash;104\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang EWJ, Davis A, Finkelstein Y, Rosenfield D (2022) The effects of COVID-19 on poisonings in the paediatric emergency department. Paediatr Child Health 27(Suppl 1):S4\u0026ndash;S8\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChang A, Schnall AH, Law R et al (2020) Cleaning and Disinfectant Chemical Exposures and Temporal Associations with COVID-19 - National Poison Data System, United States, January 1, 2020-March 31, 2020. MMWR Morb Mortal Wkly Rep 69(16):496\u0026ndash;498\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLevine M, Minns A, Ontiveros S, Thomas SH, Cantrell FL (2021) Evaluating the impact of home quarantine during the coronavirus pandemic on paediatric exploratory ingestions. Clin Toxicol (Phila) 59(7):673\u0026ndash;674\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejpe","sideBox":"Learn more about [European Journal of Pediatrics](https://www.springer.com/journal/431)","snPcode":"431","submissionUrl":"https://submission.nature.com/new-submission/431/3","title":"European Journal of Pediatrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"COVID-19, Paediatric, Injury, Paediatric intensive care","lastPublishedDoi":"10.21203/rs.3.rs-4762515/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4762515/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePURPOSE\u003c/h2\u003e \u003cp\u003eDuring the COVID-19 pandemic, lockdown posed a number of unprecedented problems. Injuries to children are a major public health concern. This study sought to determine the impact of France\u0026rsquo;s 2020 COVID-19 lockdown on hospital admissions for paediatric injuries.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eThis study was a retrospective cohort analysis of data from the French national inpatient database. Children admitted to a French hospital for an injury from January to July 2020 and 2019 were included. The number of admissions for injuries between January and July in 2020 (the study period) vs. the same period (the control period) in 2019 were recorded. Hospital admission rate ratios (HRRs) comparing 2020 with 2019 were calculated for three periods: before lockdown (January 1st to March 15th ), during lockdown (March 16th to May 10th ), and after lockdown (May 11th to July 31st ]).\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eA total of 72089 children were admitted to hospital for injuries between January and July 2020 (mean (SD) age, 8.7 (5.8)), and 84961 between January and July 2019 (mean (SD) age, 9.2 (5.7)). 12864 children (18%) were admitted during the lockdown period in 2020, and 23098 (27%) during the equivalent period in 2019 (HRR, 0.56; 95% confidence interval (CI), 0.55\u0026ndash;0.57; p\u0026thinsp;\u0026lt;\u0026thinsp;.001). During the 2020 lockdown, the risk of injury\u0026ndash;related paediatric admissions with critical care lasting for at least 1 day was lower than in 2019 (HRR 0.67; 95%CI, 0.62\u0026ndash;0.73; p\u0026thinsp;\u0026lt;\u0026thinsp;.001).\u003c/p\u003e\u003ch2\u003eCONCLUSIONS\u003c/h2\u003e \u003cp\u003e Further research could usefully examine how parents create a safe home environment for their children.\u003c/p\u003e","manuscriptTitle":"Impact of the COVID-19 lockdown period on hospital admissions for pediatric injuries: a French nationwide study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-26 14:03:02","doi":"10.21203/rs.3.rs-4762515/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-28T14:58:42+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-25T09:53:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-24T16:54:17+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-30T02:48:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"97877291203383069563610600395712920991","date":"2024-07-30T01:42:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281664860943411024440939829960332305851","date":"2024-07-27T07:31:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"290460198798820496576269605304636573224","date":"2024-07-25T05:44:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-24T19:51:54+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-07-24T01:34:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-24T01:19:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Pediatrics","date":"2024-07-18T12:07:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejpe","sideBox":"Learn more about [European Journal of Pediatrics](https://www.springer.com/journal/431)","snPcode":"431","submissionUrl":"https://submission.nature.com/new-submission/431/3","title":"European Journal of Pediatrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"13a10d2c-613d-40cf-bf21-7a58b2c416a0","owner":[],"postedDate":"August 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-12-09T16:04:07+00:00","versionOfRecord":{"articleIdentity":"rs-4762515","link":"https://doi.org/10.1007/s00431-024-05900-0","journal":{"identity":"european-journal-of-pediatrics","isVorOnly":false,"title":"European Journal of Pediatrics"},"publishedOn":"2024-12-04 15:57:41","publishedOnDateReadable":"December 4th, 2024"},"versionCreatedAt":"2024-08-26 14:03:02","video":"","vorDoi":"10.1007/s00431-024-05900-0","vorDoiUrl":"https://doi.org/10.1007/s00431-024-05900-0","workflowStages":[]},"version":"v1","identity":"rs-4762515","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4762515","identity":"rs-4762515","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}