University of California Davis Medical Center, Division of Pediatric General, Thoracic, and Fetal Surgery, Sacramento, California.
University of California Davis Medical Center, Division of Pediatric General, Thoracic, and Fetal Surgery, Sacramento, California.
J Surg Res. 2022 Nov;279:187-192. doi: 10.1016/j.jss.2022.05.022. Epub 2022 May 30.
In attempts to quell the spread of COVID-19, shelter-in-place orders were employed in most states. Increased time at home, in combination with parents potentially balancing childcare and work-from-home duties, may have had unintended consequences on pediatric falls from windows. We aimed to investigate rates of falls from windows among children during the first 6 mo of the COVID-19 pandemic.
Patients <18 y old admitted to three pediatric trauma centers (two - level 1, one - level 2) between 3/19/20 and 9/19/20 (COVID-era) were compared to a pre-COVID cohort (3/19/19 to 9/19/19). The primary outcome was the rate of falls from windows. Secondary outcomes included injury severity score (ISS), injuries sustained, and mortality.
Of 1011 total COVID-era pediatric trauma patients, 36 (3.6%) sustained falls from windows compared to 23 of 1108 (2.1%) pre-COVID era patients (OR 1.7, P = 0.05). The median ISS was seven pre-COVID versus four COVID-era (P = 0.43). The most common injuries sustained were skull fractures (30.5%), extremity injuries (30.5%), and intracranial hemorrhage (23.7%). One-fifth of patients underwent surgery (21.7% pre-COVID versus 19.4% COVID-era, P = 1.0). There was one mortality in the COVID-era cohort and none in the pre-COVID cohort (P = 1.0).
Despite overall fewer trauma admissions during the first 6 mo of the COVID-19 pandemic, the rate of falls from windows nearly doubled compared to the prior year, with substantial associated morbidity. These findings suggest a potential unintended consequence of shelter-in-place orders and support increased education on home safety and increased support for parents potentially juggling multiple responsibilities in the home.
为了遏制 COVID-19 的传播，大多数州都实施了就地避难令。在家时间的增加，加上父母可能要平衡育儿和在家工作的责任，可能对儿童从窗户坠落产生了意想不到的后果。我们旨在调查 COVID-19 大流行的前 6 个月期间儿童从窗户坠落的发生率。
在 2020 年 3 月 19 日至 9 月 19 日（COVID-19 时期）期间，在三家儿科创伤中心（两家为 1 级，一家为 2 级）收治的 <18 岁的患儿与 COVID-19 前的队列（2019 年 3 月 19 日至 9 月 19 日）进行比较。主要结果是从窗户坠落的发生率。次要结果包括伤害严重程度评分（ISS）、损伤情况和死亡率。
在总共 1011 例 COVID-19 时期的儿科创伤患者中，有 36 例（3.6%）从窗户坠落，而在 COVID-19 前时期的 1108 例患者中，有 23 例（2.1%）（比值比 1.7，P=0.05）。COVID-19 前时期的中位数 ISS 为 7，而 COVID-19 时期为 4（P=0.43）。最常见的损伤是颅骨骨折（30.5%）、四肢损伤（30.5%）和颅内出血（23.7%）。五分之一的患者接受了手术（COVID-19 前时期为 21.7%，COVID-19 时期为 19.4%，P=1.0）。COVID-19 时期的队列中有 1 例死亡，而 COVID-19 前时期的队列中没有死亡（P=1.0）。
尽管 COVID-19 大流行的前 6 个月创伤入院人数总体减少，但从窗户坠落的发生率与前一年相比几乎翻了一番，且与之相关的发病率较高。这些发现表明，就地避难令可能产生了意想不到的后果，并支持加强家庭安全方面的教育，以及为可能在家中承担多项责任的父母提供更多支持。
