Shi Yan, Kvasnovsky Charlotte, Khan Saira, Jain Shelley, Sargeant Danielle, Lamoshi Abdulraouf, Prince Jose, Sathya Chethan
Division of Pediatric Surgery, Cohen Children's Medical Center, 1111 Marcus Avenue, Suite M15, New Hyde Park, NY, 11042, USA.
Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Pediatr Surg Int. 2021 Oct;37(10):1409-1414. doi: 10.1007/s00383-021-04962-7. Epub 2021 Jul 15.
The disruptive effects on society and medical systems due to the coronavirus disease 2019 (COVID-19) pandemic are substantial and far-reaching. The effect of the pandemic on the quantity and quality of pediatric traumas is unclear and has a direct bearing on how scarce hospital resources should be allocated in a pandemic situation.
A retrospective review of the trauma registry was performed for trauma activations in the years 2018 through 2020 during the months of March, April, and May. Demographic and injury specific datapoints were compared across calendar years.
There were 111, 100, and 52 trauma activations during the study interval in 2018, 2019, and 2020, respectively. There were fewer highest severity level activations in 2020 compared to 2018 and 2019 (1 vs 5 and 9; p < 0.01). The median Injury Severity Score was 5 in 2020 compared to 4 in both 2018 and 2019 (p < 0.01). More patients went directly to the operating room in 2020 compared to prior years (21.2% vs 8% and 6.1%; p < 0.01). There were fewer discharges from the emergency department (ED) (12.1% vs 36.6% and 32.7%). No increase in the number of child abuse reports and investigations was noted. There was no difference in the proportion of blunt versus penetrating trauma between years (p = 0.57). No pedestrians were struck by automobiles in 2020 compared to 12 and 14 in 2018 and 2019. However, there were a greater proportion of injuries from falls during 2020 compared to prior years.
There were fewer trauma activations during the peak of the COVID pandemic compared to prior years. Due to the decrease in trauma volume during the peak of the pandemic, hospital resources could potentially be reallocated toward areas of greater need.
IV; Retrospective cohort study using historical controls.
2019年冠状病毒病（COVID-19）大流行对社会和医疗系统造成的破坏影响巨大且深远。大流行对儿童创伤数量和质量的影响尚不清楚，这直接关系到在大流行情况下应如何分配稀缺的医院资源。
对2018年至2020年3月、4月和5月期间创伤登记处的创伤激活情况进行回顾性研究。比较各历年的人口统计学和损伤特定数据点。
2018年、2019年和2020年研究期间的创伤激活次数分别为111次、100次和52次。与2018年和2019年相比，2020年最高严重程度级别的激活次数更少（1次对5次和9次；p＜0.01）。2020年损伤严重程度评分中位数为5，而2018年和2019年均为4（p＜0.01）。与前几年相比，2020年更多患者直接进入手术室（21.2%对8%和6.1%；p＜0.01）。急诊科出院人数减少（12.1%对36.6%和32.7%）。未发现虐待儿童报告和调查数量增加。各年份之间钝性创伤与穿透性创伤的比例无差异（p = 0.57）。与2018年的12例和2019年的14例相比，2020年没有行人被汽车撞到。然而，与前几年相比，2020年跌倒受伤的比例更高。
与前几年相比，COVID大流行高峰期的创伤激活次数更少。由于大流行高峰期创伤量减少，医院资源可能会重新分配到更有需求的领域。
IV；使用历史对照的回顾性队列研究。
