儿童创伤的流行病学在 2019 冠状病毒病大流行期间。
Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic.
机构信息
Division of Emergency and Transport Medicine, Department of Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mail Stop 113, Los Angeles, CA 90027, USA; Keck School of Medicine of the University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA.
Division of Pediatric Surgery, Department of Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.
出版信息
J Pediatr Surg. 2022 Feb;57(2):284-290. doi: 10.1016/j.jpedsurg.2021.09.054. Epub 2021 Oct 9.
BACKGROUND/PURPOSE: We aimed to describe the epidemiology of trauma activations and variations in injury patterns, injury severity, and hospital length-of-stay for injured children in Los Angeles (LA) County during the coronavirus-disease-19 (COVID-19) pandemic.
METHODS
We conducted a retrospective cross-sectional study of children aged < 18-years evaluated in 15 trauma centers from 2019 to 2020 and entered in the LA County trauma registry. We defined 01/01/2019-03/18/2020 as pre-pandemic and 03/19/2020-12/31/2020 as the pandemic period. Our primary outcome was pediatric trauma activations. We analyzed demographic and clinical data, including types and severity of injuries sustained. We conducted unadjusted bivariate analyzes of injury patterns between periods. Segmented linear regression models were used to test rates (per 100,000 LA County children) of trauma activations pre-pandemic versus the pandemic period.
RESULTS
We studied 4399 children with trauma activations, 2695 of which occurred pre-pandemic and 1701 in the pandemic period. Motor vehicle collisions, gunshot wounds, and burns increased during the pandemic (all p-values< 0.05), while sports injuries decreased (p < 0.001). Median injury severity scores (p = 0.323) and Glasgow Coma Scales (p = 0.558) did not differ between periods, however mortality (p = 0.023) decreased during the pandemic. Segmented linear regression estimates demonstrated that rates of trauma activations pre-pandemic were similar to the pandemic period (p = 0.384).
CONCLUSION
Pediatric trauma activations in LA County did not significantly differ during the COVID-19 pandemic, but types and severity of injuries varied between pre-pandemic and pandemic periods. With lockdown restrictions being lifted and novel SARS-CoV-2 variants circulating, our investigation describes this recent epidemiologic phenomenon to aid future preparation for healthcare systems.
LEVEL OF EVIDENCE
Level III TYPE OF STUDY: Retrospective cross-sectional study.
背景/目的：我们旨在描述在新冠疫情期间，洛杉矶县受伤儿童创伤激活的流行病学情况，以及损伤模式、损伤严重程度和住院时间的变化。
方法
我们对 2019 年至 2020 年期间在 15 家创伤中心接受评估并录入洛杉矶县创伤登记处的<18 岁儿童进行了回顾性横断面研究。我们将 2019 年 1 月 1 日至 2020 年 3 月 18 日定义为大流行前时期，将 2020 年 3 月 19 日至 12 月 31 日定义为大流行时期。我们的主要结局是儿科创伤激活。我们分析了人口统计学和临床数据，包括受伤类型和严重程度。我们对两个时期的损伤模式进行了未调整的双变量分析。使用分段线性回归模型来测试大流行前时期与大流行时期每 10 万洛杉矶县儿童创伤激活率（per 100,000 LA County children）。
结果
我们研究了 4399 名有创伤激活的儿童，其中 2695 名发生在大流行前时期，1701 名发生在大流行时期。机动车碰撞、枪伤和烧伤在大流行期间增加（所有 p 值均<0.05），而运动损伤减少（p<0.001）。损伤严重程度评分中位数（p=0.323）和格拉斯哥昏迷评分（p=0.558）在两个时期无差异，但大流行期间死亡率降低（p=0.023）。分段线性回归估计表明，大流行前时期的创伤激活率与大流行时期相似（p=0.384）。
结论
洛杉矶县儿科创伤激活在新冠疫情期间没有显著差异，但大流行前和大流行时期的损伤类型和严重程度有所不同。随着封锁限制的解除和新型 SARS-CoV-2 变异株的传播，我们的调查描述了这一最近的流行病学现象，以帮助医疗保健系统为未来做好准备。
证据水平
III 级 研究类型：回顾性横断面研究。
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