Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Child Abuse Negl. 2021 Jun;116(Pt 2):104756. doi: 10.1016/j.chiabu.2020.104756. Epub 2020 Sep 25.
The Covid-19 pandemic has forced mass closures of childcare facilities and schools. While these measures are necessary to slow virus transmission, little is known regarding the secondary health consequences of social distancing. The purpose of this study is to assess the proportion of injuries secondary to physical child abuse (PCA) at a level I pediatric trauma center during the Covid-19 pandemic.
A retrospective review of patients at our center was conducted to identify injuries caused by PCA in the month following the statewide closure of childcare facilities in Maryland. The proportion of PCA patients treated during the Covid-19 era were compared to the corresponding period in the preceding two years by Fisher's exact test. Demographics, injury profiles, and outcomes were described for each period.
Eight patients with PCA injuries were treated during the Covid-19 period (13 % of total trauma patients), compared to four in 2019 (4 %, p < 0.05) and three in 2018 (3 %, p < 0.05). The median age of patients in the Covid-19 period was 11.5 months (IQR 6.8-24.5). Most patients were black (75 %) with public health insurance (75 %). All injuries were caused by blunt trauma, resulting in scalp/face contusions (63 %), skull fractures (50 %), intracranial hemorrhage (38 %), and long bone fractures (25 %).
There was an increase in the proportion of traumatic injuries caused by physical child abuse at our center during the Covid-19 pandemic. Strategies to mitigate this secondary effect of social distancing should be thoughtfully implemented.
新冠疫情迫使大量儿童保育设施和学校关闭。虽然这些措施对于减缓病毒传播是必要的，但对于社交隔离的继发性健康后果知之甚少。本研究的目的是评估在新冠疫情期间，一级儿科创伤中心因躯体虐待儿童（PCA）导致的伤害比例。
对我们中心的患者进行回顾性研究，以确定马里兰州儿童保育设施关闭后一个月内因 PCA 导致的伤害。通过 Fisher 确切检验比较新冠疫情期间与前两年同期治疗的 PCA 患者比例。描述每个时期的人口统计学、损伤特征和结局。
在新冠疫情期间，有 8 名 PCA 损伤患者接受治疗（占总创伤患者的 13%），而 2019 年为 4 名（4%，p<0.05），2018 年为 3 名（3%，p<0.05）。新冠疫情期间患者的中位年龄为 11.5 个月（IQR 6.8-24.5）。大多数患者为黑人（75%），享受公共医疗保险（75%）。所有损伤均由钝器引起，导致头皮/面部挫伤（63%）、颅骨骨折（50%）、颅内出血（38%）和长骨骨折（25%）。
在新冠疫情期间，我们中心因躯体虐待儿童导致的创伤性损伤比例有所增加。应慎重实施减轻社交隔离这种继发性影响的策略。
