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The Effect of COVID-19 Shelter-in-Place Orders on Pediatric Craniofacial Trauma
Allison K Ikeda1, Russell E Ettinger2, Srinivas M Susarla2,3
1Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
Insights
Shelter-in-place orders during the pandemic led to more falls and a higher likelihood of brain injuries in children with craniofacial trauma. Injury patterns significantly changed, with falls increasing notably.
Area of Science:
- Pediatric Trauma
- Public Health Policy
- Craniofacial Surgery
Background:
- Shelter-in-place orders were implemented globally in response to the COVID-19 pandemic.
- These orders potentially altered children's environments and activities, influencing injury risks.
- Craniofacial trauma in children requires specialized care and understanding of its causes.
Purpose of the Study:
- To examine how shelter-in-place mandates affected the types of injuries sustained by pediatric patients with craniofacial trauma.
- To compare injury patterns in children treated before and after the implementation of these public health measures.
Main Methods:
- Retrospective review of pediatric (<18 years) craniofacial trauma cases at a Level I trauma center.
- Data collected included demographic information and injury details for one year pre- and post-shelter-in-place order.
- Statistical analyses, including bivariate and logistic regression, were used to compare groups.
Main Results:
- A total of 119 children were analyzed (46 pre- and 73 post-order).
- Significant differences in injury mechanisms were observed post-order (p=0.02), with a notable increase in falls (10.5%).
- Children treated post-order had a higher likelihood of associated brain injuries (OR 3.4, p=0.03).
Conclusions:
- Shelter-in-place orders were associated with a significant shift in pediatric craniofacial trauma mechanisms, particularly an increase in falls.
- The likelihood of associated brain injury in pediatric craniofacial trauma cases increased during the post-shelter-in-place period.
Abstract:
Objectives: To investigate the impacts of the shelter-in-place orders on the injury patterns among children with craniofacial trauma. Materials and Methods: Pediatric (<18 years old) craniofacial trauma cases presenting to a regional level I trauma center 1 year before and after the initiation of Washington's shelter-in-place order were retrospectively reviewed. Demographic and injury-related variables were recorded, and bivariate and logistic regression analyses were computed. Results: One hundred nineteen children were evaluated over 2-year period (46 pre- and 73 post-shelter-in-place and were comparable in age, gender, and ethnicity (p ≥ 0.17)). The distribution of injury mechanisms between pre- and post-shelter-in-place were significantly different (p = 0.02), with the largest proportional increase in falls (10.5%) and had higher rates of associated brain injury (p ≤ 0.02). After adjusting for effect modifiers and confounders, children presenting during the post-shelter-in-place period were more likely to have associated brain injuries (odds ratio 3.4, 95% confidence interval: 1.11-10.6, p = 0.03). Conclusions: Among pediatric craniofacial injury cases, the shelter-in-place order was associated with a higher likelihood of brain injury and significant changes in injury mechanisms, with a higher proportion of falls.
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