Injury Epidemiology (Dec 2023)
A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic
- Holly R. Hanson,
- Margaret Formica,
- Danielle Laraque-Arena,
- Mark R. Zonfrillo,
- Puja Desai,
- Joseph O. O’Neil,
- Purnima Unni,
- Estell Lenita Johnson,
- Patricia Cobb,
- Maneesha Agarwal,
- Kristen Beckworth,
- Stephanie Schroter,
- Stephen Strotmeyer,
- Katie A. Donnelly,
- Leah K. Middelberg,
- Amber M. Morse,
- James Dodington,
- Richard F. Latuska,
- Brit Anderson,
- Karla A. Lawson,
- Michael Valente,
- Michael N. Levas,
- Andrew Waititu Kiragu,
- Kathy Monroe,
- Stephanie M. Ruest,
- Lois K. Lee,
- Tanya Charyk Stewart,
- Megan M. Attridge,
- Maya Haasz,
- Mubeen Jafri,
- Alicia McIntire,
- Steven C. Rogers,
- Neil G. Uspal,
- Ashley Blanchard,
- Max D. Hazeltine,
- Teresa Riech,
- Charles Jennissen,
- Lynn Model,
- Quinney Fu,
- Lindsay D. Clukies,
- David Juang,
- Michelle T. Ruda,
- Jose M. Prince,
- Stephanie Chao,
- Brian K. Yorkgitis,
- Wendy J. Pomerantz
Affiliations
- Holly R. Hanson
- Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt
- Margaret Formica
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University
- Danielle Laraque-Arena
- New York Academy of Medicine
- Mark R. Zonfrillo
- Department of Emergency Medicine, Hasbro Children’s Hospital and Alpert Medical School of Brown University
- Puja Desai
- Department of Pediatrics, St. Louis Children’s Hospital and Washington University School of Medicine
- Joseph O. O’Neil
- Department of Pediatrics, Indiana University
- Purnima Unni
- Department of Pediatric Trauma, Monroe Carell Jr. Children’s Hospital at Vanderbilt
- Estell Lenita Johnson
- Department of Epidemiology, School of Public Health, Injury Free Coalition for Kids, Columbia University
- Patricia Cobb
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center
- Maneesha Agarwal
- Department of Pediatrics and Emergency Medicine, Emory University School of Medicine, Children’s Healthcare of Atlanta
- Kristen Beckworth
- Center for Childhood Injury Prevention, Texas Children’s Hospital
- Stephanie Schroter
- Department of Pediatric Emergency Medicine, University of California, Rady Children’s Hospital San Diego
- Stephen Strotmeyer
- Department of Pediatric General and Thoracic Surgery, UPMC Children’s Hospital of Pittsburgh
- Katie A. Donnelly
- Division of Emergency Medicine, Children’s National Hospital
- Leah K. Middelberg
- Division of Emergency Medicine, Department of Pediatrics, Nationwide Children’s Hospital
- Amber M. Morse
- Division of Pediatric Emergency Medicine, University of Arkansas for Medical Sciences, Arkansas Children’s Hospital
- James Dodington
- Yale School of Medicine
- Richard F. Latuska
- Division of Emergency Medicine, Children’s Hospital of Philadelphia
- Brit Anderson
- Department of Pediatric Emergency Medicine, Norton Children’s Hospital
- Karla A. Lawson
- Trauma and Injury Research Center, Dell Children’s Medical Center of Central Texas
- Michael Valente
- Department of Pediatric Emergency Medicine, Children’s Health Orange County
- Michael N. Levas
- Department of Pediatric Emergency Medicine, Medical College of Wisconsin
- Andrew Waititu Kiragu
- Department of Pediatrics, University of Minnesota and Children’s Minnesota
- Kathy Monroe
- Division of Pediatric Emergency Medicine, University of Alabama at Birmingham
- Stephanie M. Ruest
- Department of Emergency Medicine, Hasbro Children’s Hospital and Alpert Medical School of Brown University
- Lois K. Lee
- Division of Emergency Medicine, Boston Children’s Hospital
- Tanya Charyk Stewart
- Department of Paediatrics, University of Western Ontario and London Health Sciences Centre
- Megan M. Attridge
- Division of Emergency Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago
- Maya Haasz
- Department of Pediatrics, University of Colorado School of Medicine
- Mubeen Jafri
- Department of Pediatric Surgery, Oregon Health and Science University
- Alicia McIntire
- Department of Pediatric Surgery, Randall Children’s Hospital at Emanuel Legacy
- Steven C. Rogers
- Department of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children’s Hospital
- Neil G. Uspal
- Division of Emergency Medicine, University of Washington, Seattle Children’s Hospital
- Ashley Blanchard
- Department of Emergency Medicine, Columbia University Medical Center
- Max D. Hazeltine
- Department of Surgery, UMass Chan Medical School
- Teresa Riech
- Department of Pediatric Emergency Medicine, OSF Saint Francis Medical Center
- Charles Jennissen
- Department of Pediatrics, Roy J. and Lucille A. Carter College of Medicine, University of Iowa
- Lynn Model
- Department of Pediatric Surgery, Maimonides Medical Center
- Quinney Fu
- Division of Emergency Medicine, Phoenix Children’s Hospital
- Lindsay D. Clukies
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis Children’s Hospital
- David Juang
- Department of Pediatric Surgery, Children’s Mercy Hospital
- Michelle T. Ruda
- Department of Pediatrics, Children’s Memorial Hermann Hospital, UTHealth Houston
- Jose M. Prince
- Department of Pediatric Surgery, Northwell Health
- Stephanie Chao
- Division of Pediatric Surgery, Stanford School of Medicine
- Brian K. Yorkgitis
- Department of Surgery, University of FL College of Medicine – Jacksonville
- Wendy J. Pomerantz
- Division of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center
- DOI
- https://doi.org/10.1186/s40621-023-00476-z
- Journal volume & issue
-
Vol. 10,
no. 1
pp. 1 – 12
Abstract
Abstract Background Injuries, the leading cause of death in children 1–17 years old, are often preventable. Injury patterns are impacted by changes in the child’s environment, shifts in supervision, and caregiver stressors. The objective of this study was to evaluate the incidence and proportion of injuries, mechanisms, and severity seen in Pediatric Emergency Departments (PEDs) during the COVID-19 pandemic. Methods This multicenter, cross-sectional study from January 2019 through December 2020 examined visits to 40 PEDs for children < 18 years old. Injury was defined by at least one International Classification of Disease-10th revision (ICD-10) code for bodily injury (S00–T78). The main study outcomes were total and proportion of PED injury-related visits compared to all visits in March through December 2020 and to the same months in 2019. Weekly injury visits as a percentage of total PED visits were calculated for all weeks between January 2019 and December 2020. Results The study included 741,418 PED visits for injuries pre-COVID-19 pandemic (2019) and during the COVID-19 pandemic (2020). Overall PED visits from all causes decreased 27.4% in March to December 2020 compared to the same time frame in 2019; however, the proportion of injury-related PED visits in 2020 increased by 37.7%. In 2020, injured children were younger (median age 6.31 years vs 7.31 in 2019), more commonly White (54% vs 50%, p < 0.001), non-Hispanic (72% vs 69%, p < 0.001) and had private insurance (35% vs 32%, p < 0.001). Injury hospitalizations increased 2.2% (p < 0.001) and deaths increased 0.03% (p < 0.001) in 2020 compared to 2019. Mean injury severity score increased (2.2 to 2.4, p < 0.001) between 2019 and 2020. Injuries declined for struck by/against (− 4.9%) and overexertion (− 1.2%) mechanisms. Injuries proportionally increased for pedal cycles (2.8%), cut/pierce (1.5%), motor vehicle occupant (0.9%), other transportation (0.6%), fire/burn (0.5%) and firearms (0.3%) compared to all injuries in 2020 versus 2019. Conclusions The proportion of PED injury-related visits in March through December 2020 increased compared to the same months in 2019. Racial and payor differences were noted. Mechanisms of injury seen in the PED during 2020 changed compared to 2019, and this can inform injury prevention initiatives.
Keywords
