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Published on: February 23, 2024
The impact of COVID-19 on patterns of burns evaluated in pediatric emergency departments
Stephanie Ruest1, Laurie H Johnson2, Katherine T Flynn-O'Brien3
1Departments of Emergency Medicine and Pediatrics, Warren Alpert Medical School of Brown University, Rhode Island Hospital and Hasbro Children's Hospital, Providence, RI, United States.
Insights
Pediatric burn visits increased proportionally during the COVID-19 pandemic, showing shifts in demographics and injury types. These findings highlight the need for targeted burn prevention strategies.
Area of Science:
- Emergency Medicine
- Pediatric Injury Prevention
- Public Health
Background:
- Pediatric fire- and burn-related injuries are a leading cause of death and morbidity in the US.
- Limited data exists on the impact of the COVID-19 pandemic on pediatric burn injuries in emergency departments.
Purpose of the Study:
- To analyze changes in pediatric burn injury patterns before and during the COVID-19 pandemic.
- To identify demographic and injury characteristic differences in pediatric burns during the pandemic.
Main Methods:
- A multi-center cross-sectional study analyzed 741,418 injury visits to 40 pediatric emergency departments.
- Burn visits were identified using International Classification of Diseases, 10th Revision (ICD-10) codes.
- Data from March 17, 2019-December 31, 2019 (control) were compared to March 15, 2020-December 31, 2020 (pandemic).
Main Results:
- While overall burn visits decreased, their proportion relative to other injuries increased significantly during the pandemic (2.5% vs. 2.0%).
- Significant demographic shifts were observed, with higher proportions of White and non-Hispanic patients presenting with burns.
- Geographic distribution, triage urgency, trauma activations, affected body regions, intent, and mechanisms of burn injuries also differed significantly, with a notable increase in flame/fire-related burns.
Conclusions:
- Burns represented a larger fraction of pediatric emergency department visits during the COVID-19 pandemic.
- Significant variations in patient demographics and injury patterns necessitate updated burn prevention education and interventions.
Background:
Fire- and burn-related injuries are among the top 10 causes of death for children < 18 years in the United States and are associated with significant morbidity. Data regarding the impact of the COVID-19 pandemic on pediatric burns in emergency department (ED) settings are limited.
Objective:
To examine differences in pediatric burn-related injury patterns before and during the COVID-19 pandemic.
Methods:
This is a subanalysis of a multi-center cross-sectional study of 741,418 injury-related visits to 40 pediatric EDs for children < 18 years. Burn visits were identified by International Classification of Diseases, 10th Revision (ICD-10) codes. Patient demographics and burn-related injury patterns for 3/17/2019-12/31/2019 (control period) vs. 3/15/2020-12/31/2020 (pandemic study period) were compared.
Results:
Burn-related visits comprised 2.2 % (N = 12,908) of all injury visits. In 2020 there were 3.7 % fewer burn visits, but the proportion of burn visits relative to other injuries was higher (2.5 % vs. 2.0 %, p < 0.001). There were significant differences in burn visits in 2020 by race (p < 0.05) and ethnicity (p = 0.01), with higher proportions of White and non-Hispanic patients. There were significant differences in the geographic distribution of burn visits in 2020 (p < 0.001) and significantly higher proportions of more urgent triage levels (p <0.05) and trauma activations (p < 0.05). Body region affected (p < 0.01), intent (p < 0.001) and mechanism (p < 0.001) also differed significantly. A higher proportion were due to flames/fires and fewer due to hot objects.
Conclusions:
Burns comprised a higher proportion of injury-related ED visits during the pandemic, with significant differences in patient demographics and injury patterns. These results can inform burn prevention education.
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