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The Effect of COVID-19 on Pediatric Traumatic Orthopaedic Injuries: A Database Study
Ajith Malige1, Alexa Deemer, Andrew D Sobel
1From the St. Luke's University Hospital (Dr. Malige and Dr. Sobel), and the Lewis Katz School of Medicine at Temple University (Ms. Deemer).
Insights
During the COVID-19 pandemic, pediatric patients experienced more home-related injuries and a rise in child abuse cases. These shifts correlated with worse hospital outcomes, including increased mortality rates.
Area of Science:
- Orthopaedic surgery
- Pediatric trauma
- Epidemiology
Background:
- Social distancing and stay-at-home orders profoundly impacted children's lives during the COVID-19 pandemic.
- Understanding changes in pediatric injury patterns and outcomes is crucial for public health.
Purpose of the Study:
- To characterize pediatric orthopaedic injuries and in-hospital outcomes during the COVID-19 pandemic.
- To compare these patterns with pre-pandemic data.
Main Methods:
- Retrospective review of pediatric patients (<18 years) with orthopaedic injuries.
- Comparison of injury types, locations, hospital stays, and mortality between pre-COVID and COVID-19 cohorts.
Main Results:
- More injuries occurred at home during the pandemic (54.9% vs. 44.7%).
- Fewer injuries occurred in sporting areas, parks, pools, and schools.
- Child abuse-related injuries increased significantly (11.0% vs. 5.6%).
- The COVID-19 cohort experienced longer hospital stays, more ICU days, and higher mortality rates (3.8% vs. 1.3%).
Conclusions:
- Pediatric orthopaedic injury patterns shifted during the COVID-19 pandemic.
- These shifts were associated with significantly worse hospital outcomes, including increased mortality.
Introduction:
Stay-at-home orders and other social distancing restrictions had a profound effect on the lives of children during the pandemic. This study characterizes pediatric orthopaedic injuries and in-hospital outcomes during the COVID-19 pandemic and compares them with pre-COVID patterns.
Methods:
A retrospective review of pediatric patients presenting to hospitals with Pennsylvania Trauma Systems Foundation designations was performed. All patients younger than 18 years who presented with orthopaedic injuries were included. Patient demographics, injuries, hospital stays, and mortality were compared between the COVID and pre-COVID cohorts.
Results:
Overall, 1112 patients were included. During the pandemic, more injuries occurred at home (44.7% versus 54.9%, P = 0.01) and fewer at sporting areas, parks, and pools (7.8% versus 1.6%, P < 0.01) as well as at schools (3.4% versus 0.5%, P = 0.03). Injuries caused by child abuse were more prevalent during the pandemic (5.6% versus 11.0%, P < 0.01). Finally, the COVID cohort had a longer mean hospital length of stay (3.1 versus 2.4 days, P = 0.01), higher mean number of ICU days (1.0 versus 0.7 days, P = 0.02), and higher mortality rate (3.8% versus 1.3%, P = 0.02).
Discussion:
Pediatric patients sustained injuries in differing patterns during the pandemic, but these led to worse hospital outcomes, including higher mortality rates.
