Injury Patterns and Outcomes at a Single Pediatric Trauma Center During the Coronavirus Disease 19 Pandemic
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Travis M Sullivan1, Daniel Scheese1, Eisha Jain2
1Department of Surgery, Virginia Commonwealth University Health System, Richmond, Virginia.
Insights
The COVID-19 pandemic led to more injured children requiring hospital admission, with a rise in penetrating trauma and in-hospital mortality during the first year. This highlights the need for trauma system preparedness during societal disruptions.
Area of Science:
- Pediatric Trauma Care
- Epidemiology of Injury
- Public Health Policy
Background:
- The COVID-19 pandemic altered injury patterns and outcomes nationally.
- Variations in public health policies complicate aggregate data interpretation.
- A single pediatric trauma center compared pre-pandemic and pandemic injury data.
Purpose of the Study:
- To compare pediatric injury patterns and outcomes before and during the COVID-19 pandemic.
- To inform trauma system preparedness for future societal shutdowns.
Main Methods:
- Retrospective review of trauma registry and electronic medical records.
- Inclusion criteria: injured children (<15 years) requiring admission.
- Statistical analysis included univariate and multivariable regression.
Main Results:
- Increased admissions for injured children during the first pandemic year.
- Significant rise in penetrating injuries (firearm and non-firearm) in the first year.
- Increased in-hospital mortality during the first pandemic year (P=0.04).
Conclusions:
- Psychosocial and socioeconomic impacts of COVID-19 may drive increased penetrating injuries and mortality.
- Findings support data-informed trauma system resource allocation for future crises.
- Preparedness for societal shutdowns is crucial for pediatric trauma centers.
Introduction:
The coronavirus disease 19 (COVID-19) pandemic is reported to have changed injury patterns, prevalence, and outcomes across multiple institutions in the United States. Interpretation of aggregate data is difficult because injury patterns vary between urban and rural hospitals and the implementation of locoregional public health policies and guidelines in response to COVID-19 differed. To prepare our trauma system for future societal shutdowns, we compared injury patterns and outcomes of injured children and adolescents at a single pediatric trauma center before and during the first 2 y of the COVID-19 pandemic.
Methods:
We abstracted demographic, injury, and outcome data for injured children and adolescents (age <15 y) who required admission using our hospital trauma registry and the electronic medical record. We compared differences prior to and during the COVID-19 pandemic using univariate analysis. To address confounding variables, we also analyzed in-hospital mortality using a multivariable regression.
Results:
We observed an increase in the number of injured children requiring admission during the first year of the COVID-19 pandemic compared to the prepandemic era. Among injury types sustained, we observed an increase in firearm and nonfirearm related penetrating injuries (P < 0.001) during the first year, but not the second year, of the COVID-19 pandemic. Controlling for several confounding variables, we also observed an increase in in-hospital mortality (P = 0.04) during the first year of the COVID-19 pandemic.
Conclusions:
The psychosocial and socioeconomic burden of the COVID-19 pandemic may have contributed to the rise in penetrating injuries and the odds of in-hospital mortality among a cohort of children and adolescents who were admitted to our hospital following injury. This data may be used to prepare our trauma system for future societal shutdowns through data informed resource utilization.
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