Le Bonheur Children's Hospital, Memphis, Tennessee.
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Surg Res. 2022 Aug;276:110-119. doi: 10.1016/j.jss.2022.02.038. Epub 2022 Feb 24.
There has been concern that the incidence of non-accidental trauma (NAT) cases in children would rise during the COVID-19 pandemic due to the combination of social isolation and economic depression. Our goal was to evaluate NAT incidence and severity during the pandemic across multiple US cities.
Multi-institutional, retrospective cohort study comparing NAT rates in children <18 y old during the COVID-19 pandemic (March-August 2020) with a recent historical data (January 2015-February 2020) and during a previous economic recession (January 2007-December 2011) at level 1 Pediatric Trauma Centers. Comparisons were made in local and national macroeconomic indicators.
Overall rates of NAT during March-August 2020 did not increase compared to historical data (P = 0.8). Severity of injuries did not increase during the pandemic as measured by Glasgow Coma Scale (GCS) (P = 0.97) or mortality (P = 0.7), but Injury Severity Score (ISS) slightly decreased (P = 0.018). Racial differences between time periods were seen, with increased proportions of NAT occurring in African-Americans during the pandemic (P < 0.001). NAT rates over time had low correlation (r = 0.32) with historical averages, suggesting a difference from previous years. Older children (≥3 y) had increased NAT rates during the pandemic. Overall NAT rates had low inverse correlation with unemployment (r = -0.37) and moderate inverse correlation with the stock market (r = -0.6). Significant variation between sites was observed.
Overall NAT rates in children did not increase during the COVID-19 pandemic, but rates were highly variable by site and increases were seen in African-Americans and older children. Further studies are warranted to explore local influences on NAT rates.
由于社会隔离和经济萧条的综合影响，人们担心 COVID-19 大流行期间儿童非意外伤害（NAT）病例的发生率会上升。我们的目标是评估多个美国城市在大流行期间 NAT 的发生率和严重程度。
多机构、回顾性队列研究比较了 COVID-19 大流行期间（2020 年 3 月至 8 月）年龄<18 岁儿童的 NAT 发生率与近期历史数据（2015 年 1 月至 2020 年 2 月）和之前经济衰退（2007 年 1 月至 2011 年 12 月）期间 1 级儿科创伤中心的数据。比较了当地和国家宏观经济指标。
与历史数据相比，2020 年 3 月至 8 月期间 NAT 的总体发生率没有增加（P=0.8）。大流行期间，格拉斯哥昏迷量表（GCS）（P=0.97）或死亡率（P=0.7）测量的伤害严重程度没有增加，但损伤严重程度评分（ISS）略有下降（P=0.018）。不同时期存在种族差异，大流行期间非裔美国人发生 NAT 的比例增加（P<0.001）。随着时间的推移，NAT 发生率与历史平均值的相关性较低（r=0.32），表明与前几年有所不同。年龄较大的儿童（≥3 岁）在大流行期间 NAT 发生率增加。总体而言，NAT 发生率与失业率呈低负相关（r=-0.37），与股市呈中度负相关（r=-0.6）。观察到站点之间存在显着差异。
在 COVID-19 大流行期间，儿童的总体 NAT 发生率没有增加，但各站点的发生率差异很大，非裔美国人和年龄较大的儿童的发生率增加。需要进一步研究以探讨 NAT 率的局部影响。
