Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
J Craniofac Surg. 2023;34(1):e1-e6. doi: 10.1097/SCS.0000000000008776. Epub 2022 Jul 22.
The effect of physical-distancing policies and school closures on pediatric health has been a topic of major concern in the United States during the coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to assess the immediate impact of these public policies on patterns of head and facial trauma in the pediatric population.
The Pediatric Health Information System (PHIS) was queried to identify patient encounters at 46 children's hospitals across the United States in 2016-2020. Encounters were included if resultant in ICD-10 diagnosis for head or facial trauma in a child under 18 between April 1 and June 30 in 2020 (first COVID-19 school closures) and during the same period in the previous 4 years (for comparison).
A total of 170,832 patient encounters for pediatric head and facial trauma were recorded during the study period, including 28,030 (16.4%) in 2020 and 142,802 (83.6%) in 2016-2019. Patient encounters declined significantly in 2020 among children of all age groups relative to previous years. Relative reductions were greatest in children aged 11 to 17 (middle/high school) and 6 to 10 (elementary school), at -34.6% (95% confidence interval: -23.6%, -44%; P <0.001) and -27.7% (95% confidence interval: -18.4%, -36%; P <0.001). Variation in relative reductions by race/ethnicity, sex, and rural/urban status were not statistically significant.
Physical-distancing policies and school closures at the start of the COVID-19 pandemic correlated with significant reductions in pediatric head and facial trauma patient encounters. As in-person activities resume, reductions in head and facial trauma during the pandemic may indicate a range of possible preventable injuries in the future.
在 2019 年冠状病毒病（COVID-19）大流行期间，物理隔离政策和学校关闭对儿科健康的影响一直是美国关注的主要问题。本研究的目的是评估这些公共政策对儿科人群头部和面部创伤模式的直接影响。
通过查询美国 46 家儿童医院的儿科健康信息系统（PHIS），确定了 2016 年至 2020 年期间美国各地儿童的就诊情况。如果在 2020 年 4 月 1 日至 6 月 30 日期间（首次 COVID-19 学校关闭）和前 4 年的同期（用于比较），18 岁以下儿童因头部或面部创伤而导致 ICD-10 诊断的就诊情况，则将其纳入研究。
在研究期间共记录了 170832 例儿科头部和面部创伤患者就诊情况，其中 2020 年为 28030 例（16.4%），2016 年至 2019 年为 142802 例（83.6%）。与前几年相比，所有年龄段的儿童在 2020 年的就诊人数均明显下降。降幅最大的是 11 至 17 岁（中学）和 6 至 10 岁（小学）儿童，分别为-34.6%（95%置信区间：-23.6%，-44%；P <0.001）和-27.7%（95%置信区间：-18.4%，-36%；P <0.001）。种族/民族、性别和城乡状况的相对减少差异无统计学意义。
COVID-19 大流行开始时实施的物理隔离政策和学校关闭与儿科头部和面部创伤患者就诊人数的显著减少相关。随着面对面活动的恢复，大流行期间头部和面部创伤的减少可能表明未来可能会出现一系列可预防的伤害。
