Department of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
Children's Hospital Association, Lenexa, Kansas.
Pediatrics. 2022 Oct 1;150(4). doi: 10.1542/peds.2021-054545.
To describe the epidemiology of pediatric injury-related visits to children's hospital emergency departments (EDs) in the United States during early and later periods of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.
We conducted a cross-sectional study using the Pediatric Health Information System, an administrative database to identify injury-related ED visits at 41 United States children's hospitals during the SARS-CoV-2 pandemic period (March 15, 2020 to March 14, 2021) and a 3 year comparator period (March 15-March 14, 2017-2020). For these 2 periods, we compared patient characteristics, injury type and severity, primary discharge diagnoses, and disposition, stratified by early (March 15, 2020 to June 30, 2020), middle (July 1, 2020 to October 31, 2020), and late (November 1, 2020 to March 14, 2021) pandemic periods.
Overall, ED injury-related visits decreased by 26.6% during the first year of the SARS-CoV-2 pandemic, with the largest decline observed in minor injuries. ED injury-related visits resulting in serious-critical injuries increased across the pandemic (15.9% early, 4.9% middle, 20.6% late). Injury patterns with the sharpest relative declines included superficial injuries (41.7% early) and sprains/strains (62.4% early). Mechanisms of injury with the greatest relative increases included (1) firearms (22.9% early; 42.8% middle; 37% late), (2) pedal cyclists (60.4%; 24.9%; 32.2%), (3) other transportation (20.8%; 25.3%; 17.9%), and (4) suffocation/asphyxiation (21.4%; 20.2%; 28.4%) and injuries because of suicide intent (-16.2%, 19.9%, 21.8%).
Pediatric injury-related ED visits declined in general. However, there was a relative increase in injuries with the highest severity, which warrants further investigation.
描述美国儿童医院急诊部（ED）因小儿损伤就诊的流行病学情况，包括 SARS-CoV-2 大流行的早期和后期。
我们使用儿科健康信息系统进行了一项横断面研究，该系统是一个行政数据库，用于识别 SARS-CoV-2 大流行期间（2020 年 3 月 15 日至 2021 年 3 月 14 日）和 3 年对照期（2017 年至 2020 年 3 月 15 日）在美国 41 家儿童医院因损伤就诊的 ED 病例。对于这两个时期，我们按早期（2020 年 3 月 15 日至 2020 年 6 月 30 日）、中期（2020 年 7 月 1 日至 2020 年 10 月 31 日）和晚期（2020 年 11 月 1 日至 2021 年 3 月 14 日）对患者特征、损伤类型和严重程度、主要出院诊断和出院情况进行了比较。
总体而言，SARS-CoV-2 大流行的第一年，ED 损伤相关就诊量下降了 26.6%，轻度损伤的下降幅度最大。大流行期间，因严重-危急损伤就诊的 ED 损伤相关就诊量增加（早期 15.9%，中期 4.9%，晚期 20.6%）。相对下降幅度最大的损伤类型包括浅表损伤（早期 41.7%）和扭伤/拉伤（早期 62.4%）。损伤机制中相对增加幅度最大的包括（1）枪支（早期 22.9%，中期 42.8%，晚期 37%）、（2）骑自行车的人（60.4%，24.9%，32.2%）、（3）其他交通工具（20.8%，25.3%，17.9%）和（4）窒息/窒息（21.4%，20.2%，28.4%）和自杀意图所致损伤（-16.2%，19.9%，21.8%）。
一般来说，儿科损伤相关 ED 就诊量有所下降。然而，最严重损伤的相对增加值得进一步调查。
