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Evaluating the Regional Differences in Pediatric Injury Patterns During the COVID-19 Pandemic
Amelia T Collings1, Manzur Farazi2, Kyle J Van Arendonk2
1Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
Insights
Pediatric injury patterns varied significantly across US trauma centers during the COVID-19 pandemic. Bicycle and penetrating injuries saw notable increases, highlighting regional differences in trauma response.
Area of Science:
- Pediatric Trauma
- Epidemiology
- Public Health
Background:
- Conflicting reports exist on pediatric injury patterns during the COVID-19 pandemic.
- Existing data lacks regional granularity to understand variations in pediatric trauma.
Purpose of the Study:
- To investigate variations in pediatric injury patterns across US trauma centers during the COVID-19 pandemic.
- To compare injury data from a COVID-19 cohort with historical controls.
Main Methods:
- Multicenter retrospective study of pediatric trauma patients (<18 years).
- Comparison of patients injured during COVID-19 stay-at-home orders (COVID cohort) with historical controls (2016-2019).
- Analysis of injury type, intent, and mechanism at the site level.
Main Results:
- Overall trauma volume increased in the COVID cohort, but with site-specific decreases and increases.
- Bicycle injuries increased at all sites (24%-135%).
- Penetrating injuries showed a greater relative increase than blunt injuries at most sites.
Conclusions:
- Significant discrepancies in pediatric injury patterns were observed across individual trauma centers.
- Sociopolitical climate and local pandemic policies may influence injury trends.
- Further investigation into community responses during stress is needed for future preparedness.
Introduction:
Reports of pediatric injury patterns during the COVID-19 pandemic are conflicting and lack the granularity to explore differences across regions. We hypothesized there would be considerable variation in injury patterns across pediatric trauma centers in the United States.
Materials And Methods:
A multicenter, retrospective study evaluating patients <18 y old with traumatic injuries meeting National Trauma Data Bank criteria was performed. Patients injured after stay-at-home orders through September 2020 ("COVID" cohort) were compared to "Historical" controls from an averaged period of equivalent dates in 2016-2019. Differences in injury type, intent, and mechanism were explored at the site level.
Results:
47,385 pediatric trauma patients were included. Overall trauma volume increased during the COVID cohort compared to the Historical (COVID 7068 patients versus Historical 5891 patients); however, some sites demonstrated a decrease in overall trauma of 25% while others had an increase of over 33%. Bicycle injuries increased at every site, with a range in percent change from 24% to 135% increase. Although the greatest net increase was due to blunt injuries, there was a greater relative increase in penetrating injuries at 7/9 sites, with a range in percent change from a 110% increase to a 69% decrease.
Conclusions:
There was considerable discrepancy in pediatric injury patterns at the individual site level, perhaps suggesting a variable impact of the specific sociopolitical climate and pandemic policies of each catchment area. Investigation of the unique response of the community during times of stress at pediatric trauma centers is warranted to be better prepared for future environmental stressors.
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