Emergency department visits for pediatric traumatic injuries during general confinement: A single-center study in an urban setting

Rougereau, Grégoire; Guedj, Romain; Irtan, Sabine; Qassemyar, Q.; Vialle, Raphaël; Langlais, Tristan

doi:10.1016/j.arcped.2021.02.012

Cited by 8 publications

(12 citation statements)

References 3 publications

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“…Although some reports have described decreases in pediatric trauma volumes during the COVID-19 pandemic,[ [6] , [7] , [8] , [9] , 15 ] we found overall rates of pediatric trauma activations in LA County did not change significantly compared to the pre-pandemic period. After the California statewide stay-at-home order on March 19 th , 2020, in LA County there were 3 additional dates in 2020 when pandemic control measures were substantially changed.…”

Section: Discussioncontrasting

confidence: 80%

“…LA County, which contains over 2.1 million children, is serviced by 15 Level 1 and 2 trauma centers, including 1 American College of Surgeons (ACS)-verified Level 1 Pediatric Trauma Center. Although decreased rates of traumatic injuries have been previously reported during the pandemic, [6] , [7] , [8] , [9] we observed stable trauma volumes at our pediatric trauma center. The unique epidemiology of pandemic surges experienced in LA County provided an opportunity to study the pandemic's effect on pediatric trauma volumes, injury patterns, and severity of traumatic injuries.…”

Section: Introductionmentioning

confidence: 45%

“… [1] , [2] , [3] Similarly, overall visits for injuries also declined[ 1 , 4 , 5 ] and single center reports describe similar declines in pediatric trauma volumes during the pandemic. [6] , [7] , [8] , [9] The late 2020 surge in LA County significantly altered referral patterns and emergency medical services mandates for both medical and trauma patients within LA County due to the overwhelming effect of COVID-19 on the pre-hospital and hospital systems.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic

Chaudhari

Anderson

Ourshalimian

et al. 2022

Journal of Pediatric Surgery

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Background/Purpose We aimed to describe the epidemiology of trauma activations and variations in injury patterns, injury severity, and hospital length-of-stay for injured children in Los Angeles (LA) County during the coronavirus-disease-19 (COVID-19) pandemic. Methods We conducted a retrospective cross-sectional study of children aged <18-years evaluated in 15 trauma centers from 2019-2020 and entered in the LA County trauma registry. We defined 01/01/2019-03/18/2020 as pre-pandemic and 03/19/2020-12/31/2020 as the pandemic period. Our primary outcome was pediatric trauma activations. We analyzed demographic and clinical data, including types and severity of injuries sustained. We conducted unadjusted bivariate analyses of injury patterns between periods. Segmented linear regression models were used to test rates (per 100,000 LA County children) of trauma activations pre-pandemic versus the pandemic period. Results We studied 4,399 children with trauma activations, 2,695 of which occurred pre-pandemic and 1,701 in the pandemic period. Motor vehicle collisions, gunshot wounds, and burns increased during the pandemic (all p-values<0.05), while sports injuries decreased (p<0.001). Median injury severity scores (p=0.323) and Glasgow Coma Scales (p=0.558) did not differ between periods, however mortality (p=0.023) increased during the pandemic. Segmented linear regression estimates demonstrated that rates of trauma activations pre-pandemic were similar to the pandemic period (p=0.384). Conclusion Pediatric trauma activations in LA County did not significantly differ during the COVID-19 pandemic, but types and severity of injuries varied between pre-pandemic and pandemic periods. With lockdown restrictions being lifted and novel SARS-CoV-2 variants circulating, our investigation describes this recent epidemiologic phenomenon to aid future preparation for healthcare systems.

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Section: Discussioncontrasting

confidence: 80%

Section: Introductionmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

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Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic

Chaudhari

Anderson

Ourshalimian

et al. 2022

Journal of Pediatric Surgery

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“…However, this is not the first study that assesses the impact of COVID-19 on the pediatric population. Rougereau et al performed a single-center study reporting pediatric hospital admission incidence in a teaching hospital in Paris [ 29 ]. Different to our study, Rougereau and colleagues did not thoroughly investigate the specific pattern of traumas and fractures.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Changed the Incidence and the Pattern of Pediatric Traumas: A Single-Centre Study in a Pediatric Emergency Department

Ruzzini

Salvatore

Lamberti

et al. 2021

IJERPH

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The first wave of COVID-19 spread worldwide from March to May 2020. Italy was one of the countries in the world where the lockdown period was most prolonged and restrictive. To date, the impact of prolonged lockdown on pediatric traumas has not fully investigated. This paper aimed to analyze, and compare to 2019, the incidence and the fracture pattern in patients admitted to our pediatric hospital during the total lockdown period. A single-center retrospective study was performed. The data were gathered from the Pediatric Emergency Department (PED) of the Bambino Gesù Children Hospital of Rome (Palidoro). This PED is the pediatric referral center for Rome and the hub for pediatric traumas of the region. Any admission diagnosis for fracture, trauma, sprains and dislocation during the lockdown period (10 March–4 May) were included. The demographic data, diagnosis, type of treatment, fracture segment, bone involvement and time interval between trauma and presentation to the PED were recorded. In 2020, a reduction of total traumas and fractures, compared to 2019 (p < 0.001), occurred (81%). Superior limb and inferior limb fractures decreased in 2020 compared to 2019 (p < 0.05). The identification of pediatric traumas and fractures trend could be useful to reorganize the PED. Epidemiological data from the previous lockdown could be helpful to prepare the healthcare system for new pandemic waves. Moreover, sharing national statistics and correlating those to other countries’ protocols, could be helpful to solve problems in case of worldwide emergency situations.

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“…12 In France, one study that specifically assessed emergency department attendances showed that the lockdown confinement increased the incidence of burns but not of any other childhood trauma. 13 Indeed, the significant reduction in supervision orders issued between March and May 2020 (24) compared with the same period for 2019 (136), prompted authors of another French study to question whether cases of child abuse were being undetected during lockdown. 14 One exploratory study examining police referrals from domestic abuse before and during the first enforced national lockdown in South Wales, UK, found increased third party of reporting by children.…”

Section: Original Researchmentioning

confidence: 99%

Rate and severity of radiological features of physical abuse in children during the first UK-wide COVID-19 enforced national lockdown

et al. 2022

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Rate and severity of radiological features of physical abuse in children during the first UK-wide COVID-19 enforced national lockdown.ObjectiveTo assess the number, type and outcome of radiological investigations for children presenting to hospital with suspected physical abuse (SPA; including abusive head trauma) during the first national COVID-19 enforced lockdown compared with the prelockdown period.DesignMulticentre, retrospective, observational, interrupted time series analysis.SettingEight secondary/tertiary paediatric centres between January 2018 and July 2020 inclusive.Participants1587 hospital assessed children undergoing radiographic skeletal surveys (SkS) and head CT imaging performed for SPA/child protection concerns.Main outcome measuresIncidence and severity of fractures identified on SkS; head injury (composed of incidence rates and ratios of skull fracture, intracranial haemorrhage (ICH) and hypoxic ischaemic injury (HII)) on head CT imaging; and ratio of antemortem and postmortem SkS.Results1587 SkS were performed: 1282 (81%) antemortem, 762 (48%) male, and positive findings in 582 (37%). Median patient age was 6 months. There were 1.7 fractures/child prelockdown versus 1.1 fractures/child during lockdown. There was no difference between positive/negative SkS rates, the absolute ratio of antemortem/postmortem SkS or absolute numbers of head injury occurring between January 2018 and February 2020 and the lockdown period April–July 2020. Likewise, prelockdown incidence and rates of skull fracture 30/244 (12%), ICH 28/220 (13%) and HIE 10/205 (5%) were similar to lockdown, 142/1304 (11%), 171/1152 (15%) and 68/1089 (6%), respectively.ConclusionThe first UK COVID-19 lockdown did not lead to an increase in either the number of antemortem or postmortem radiological investigations performed for SPA, or the number or severity of fractures and intracranial injuries identified by these investigations.

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Emergency department visits for pediatric traumatic injuries during general confinement: A single-center study in an urban setting

Cited by 8 publications

References 3 publications

Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic

Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic

COVID-19 Changed the Incidence and the Pattern of Pediatric Traumas: A Single-Centre Study in a Pediatric Emergency Department

Rate and severity of radiological features of physical abuse in children during the first UK-wide COVID-19 enforced national lockdown

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