Background Childhood unintentional injuries are the leading cause of death and disability for children. Despite the risk factors that lead to the occurrence of injuries have been identified, the relationship between cumulative effect of risk/protective factors and unintentional injuries is unclear. The aim of this study was to explore the cumulative effect of risk factors as well as protective factors and their interaction on unintentional injury to rural children. Methods We used a nested case-control study design from a cohort database. The study comprised 1696 children aged 6 to 14 years. Among them, 424 were cases with unintentional injury and 1272 were their matched control. After controlling for the significant sociodemographic variables, linear and logistic regression analyses were performed. Results The risk of unintentional injury increased with the increasing number of risk factors - RFI from 1 to 3 (ORRFI(1) = 0.978, 95% CI 0.739–1.296), (ORRFI(2) = 1.720, 95% CI 1.233–2.397), (ORRFI(3) = 5.162, 95% CI 3.129–8.517). PFI (1) was associated with lower risk of injury, but this association was at the edge of significance (p = 0.052). The increased risk in those with PFI (2) was not significant (p = 0.254). The severity of the unintentional injury significantly increased with the increasing number of the risk factors (p < 0.01), and significantly decreased with both the increasing number of protective factors (p = 0.001) and interaction of the risk and protective factors (p < 0.01).The interaction of RFI and PFI could explain 32.2% of the unintentional injury severity. Conclusions According to the findings of the present study, cumulative risk factors and protective factors, as well as their interaction were associated with the occurrence and/ or severity of unintentional injury in children.
Background: Childhood unintentional injuries are the leading cause of death and disability for children. Despite the risk factors that lead to injury occurrence have been identified, the relationship between cumulative risk effect of risk/protection factors on unintentional injuries are unclear. The aim of this study was to explore the cumulative risk effect on unintentional injury of rural children.Methods: We used a nested case-control study design from a cohort database. Cases were children aged 6 to 14 with unintentional injury recorded, including 1,696 children which comprised 424 unintentional injury cases and matched on 1,272 control children. Risk factor index (RFI) and protection factor index (PFI) were used as dependent variables. Binary logistic regressions was used to estimate RFI, PFI and cumulative effect odds ratios (OR) with 95% confidence intervals (CI) for childhood unintentional injury. The linear regression was performed to estimate the effect between RFI, PFI, interactive effect on unintentional injury.Results: The RFI had a significant difference between the two groups (p <0.01). After controlling the significant sociodemographic variables, the risk of unintentional injury increased with the RFI from 1 to 3 (ORRFI(1) = 0.978, 95% CI 0.739-1.296), (ORRFI(2) = 1.720, 95% CI 1.233-2.397), (ORRFI(3) = 5.162, 95% CI 3.129-8.517). While inversely it decreased with PFI increased/increasing. The linear regression indicated RFI, PFI and interactive effect were significant in the regression model, and the interactive effect of RFI⨯ PFI could be used to explain 32.2% the severity of unintentional injury.Conclusions: The cumulative risk effect on unintentional injury could regulate the unintentional injury in childhood. Pediatric care providers should consider a multifactorial interventions especially for the cumulative effect of risk/protection factors for childhood unintentional injury.
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