Department of Pediatrics, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States.
Department of Pediatrics, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States.
Injury. 2022 Oct;53(10):3289-3292. doi: 10.1016/j.injury.2022.08.011. Epub 2022 Aug 8.
Gaps remain in our understanding on how COVID19 affects trends in pediatric trauma, the leading cause of mortality and morbidity during childhood and adolescence.
We compared high acuity trauma visits (requiring admission, surgery, or fatality) presenting between March through February 2021 to corresponding months in 2017-2019. We evaluated the differences in mechanisms of injury, age, and Area Deprivation Index (ADI), a measure of socioeconomic disadvantage, during this time period. Data were analyzed using longitudinal time series analyses and t-tests.
Of 687 traumas presenting from March 2020 through February 2021, 322 were high acuity traumas. High acuity traumas declined significantly to a nadir of 16 in April 2020. High acuity traumas increased and surpassed previous years to a peak of 40 visits in August 2020 and from October through December 2020. There were more visits for high acuity assaults and confirmed or suspected physical child abuse but fewer for falls, drownings, and motor vehicle accidents from March to August 2020 and from October through December 2020 compared to prior years. High acuity assaults and physical child abuse cases on average were from the most disadvantaged areas, and physical child abuse patients were younger during the peak of the Pandemic compared to Pre-Pandemic months.
This analysis provides insight into how the COVID19 pandemic has affected high acuity trauma in an inner-city pediatric population. Findings may be used to guide public health measures on safety and injury prevention as the pandemic continues.
我们对于 COVID19 如何影响儿童创伤趋势的理解仍存在差距，儿童和青少年时期创伤是导致死亡和发病的主要原因。
我们比较了 2020 年 3 月至 2021 年 2 月与 2017 年至 2019 年同期的高急症创伤就诊（需要入院、手术或死亡）。在此期间，我们评估了损伤机制、年龄和区域贫困指数（ADI）的差异，ADI 是衡量社会经济劣势的指标。使用纵向时间序列分析和 t 检验对数据进行分析。
在 2020 年 3 月至 2021 年 2 月期间就诊的 687 例创伤中，有 322 例为高急症创伤。高急症创伤在 2020 年 4 月降至最低点 16 例。高急症创伤增加并超过了前几年，在 2020 年 8 月达到 40 例就诊高峰，并在 2020 年 10 月至 12 月期间持续升高。与前几年相比，2020 年 3 月至 8 月和 10 月至 12 月期间，高急症创伤中的攻击和确诊或疑似躯体虐待儿童的就诊次数更多，而跌倒、溺水和机动车事故的就诊次数更少。高急症攻击和躯体虐待儿童的案例平均来自最贫困的地区，而且在大流行高峰期，躯体虐待儿童患者比大流行前几个月更年轻。
这项分析深入了解了 COVID19 大流行如何影响城市内儿童的高急症创伤。研究结果可用于指导大流行期间的安全和伤害预防公共卫生措施。
