Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital.

Autor: Sanford EL; Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas TX, United States; Children's Health, Division of Pediatric Anesthesiology, Dallas TX, United States; Children's Health, Division of Pediatric Critical Care, Dallas TX, United States; Outcome Research Consortium, Cleveland, OH, United States., Zagory J; Department of Surgery, Division of Pediatric Surgery, Louisiana State University Health Sciences Center, New Orleans LA, United States; Department of Surgery, Division of Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas TX, United States. Electronic address: jzagor@lsuhsc.edu., Blackwell JM; Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas TX, United States., Szmuk P; Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas TX, United States; Children's Health, Division of Pediatric Anesthesiology, Dallas TX, United States; Outcome Research Consortium, Cleveland, OH, United States., Ryan M; Department of Surgery, Division of Pediatric Surgery, University of Texas Southwestern Medical Center, Dallas TX, United States., Ambardekar A; Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas TX, United States; Children's Health, Division of Pediatric Anesthesiology, Dallas TX, United States.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2021 May; Vol. 56 (5), pp. 918-922. Date of Electronic Publication: 2021 Jan 20.
DOI: 10.1016/j.jpedsurg.2021.01.020
Abstrakt: Background: Trauma is the leading cause of morbidity and mortality in the pediatric population. However, during the societal disruptions secondary to the coronavirus (COVID-19) stay-at-home regulations, there have been reported changes to the pattern and severity of pediatric trauma. We review our two-institution experience.
Methods: Pediatric trauma emergency department (ED) encounters from the National Trauma Registry for a large, tertiary, metropolitan level 1 pediatric trauma center and pediatric burn admission at the regional burn center were extracted for children less than 19 years from March 15th thru May 15th during the years 2015-2020. The primary outcome was the difference in encounters during the COVID-19 (2020) epoch versus the pre-COVID-19 epoch (2015-2019).
Results: There were 392 pediatric trauma encounters during the COVID-19 epoch as compared to 451, 475, 520, 460, 432 (mean 467.6) during the pre-COVID-19 epoch. Overall trauma admissions and ED trauma encounters were significantly lower (p < 0.001) during COVID-19. Burn injury admissions (p < 0.001) and penetrating trauma encounters (p = 0.002) increased during the COVID-19 epoch while blunt trauma encounters decreased (p < 0.001). Trauma occurred among more white (p = 0.01) and privately insured (p < 0.001) children, but no difference in suspected abuse, injury severity, mortality, age, or gender were detected. Sub-analysis showed significant decreases in motor vehicle crashes (p < 0.001), pedestrians struck by automobile (p < 0.001), all-terrain vehicle (ATV)/motorcross/bicycle/skateboard involved injuries (p = 0.02), falls (p < 0.001), and sports related injuries (p < 0.001). Fewer injuries occurring in the playground or home play equipment such as trampolines neared significance (p = 0.05). Interpersonal violence (assault, NAT, self-harm) was lower during the COVID-19 era (p = 0.04). For burn admissions, there was a significant increase in flame burns (p < 0.001).
Conclusions: Stay-at-home regulations alter societal patterns, leading to decreased overall and blunt traumas. However, the proportion of penetrating and burn injuries increased. Owing to increased stressors and time spent at home, healthcare professionals should keep a high suspicion for abuse and neglect.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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