Delbrück Heide, Lambertz Ellen, Migliorini Filippo, Berger Nina, Hildebrand Frank
Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy.
Eur J Trauma Emerg Surg. 2024 Apr;50(2):591-601. doi: 10.1007/s00068-024-02453-7. Epub 2024 Jan 30.
The study investigates changes in the injury characteristics of hospitalised children in a paediatric trauma centre during the COVID-19 pandemic.
Data from injured children from the pre-pandemic year 2019 were compared to the pandemic year 2020 using Pearson's chi-squared test and the Mann-Whitney U test. The period of highly restrictive regulations (HRP) was evaluated separately. A comprehensive literature review with defined search terms resulted in a descriptive data synthesis.
Data from 865 patients indicated reductions in admissions of 5.6% and 54.4% during the HRP. In 2020, the hospitalisation time was longer (2.2 ± 2.7 days in 2019 vs. 2.4 ± 2.6 in 2020, p = 0.045); the proportions of wounds requiring surgical therapy (p = 0.008) and of observational treatments, primarily for mild brain injuries (p = 0.046), were higher; and conservative treatments, primarily for contusions, were lower (p = 0.005). There were no significant changes in age, location of lesions, or frequency of surgical therapy; nor were there differences in the HRP, except for fewer injuries in school and kindergarten (p < 0.001). The literature review summarises the main results of 79 studies.
Limited resources did not alter the indications for surgical therapy. Further studies should examine whether the more common injuries sustained at home were caused by excessive work/childcare demands on parents. Reduced inpatient conservative treatment implies that hospital resources possibly were overused previously. The literature offers answers to many detailed questions regarding childhood injuries during a pandemic and more efficient safe treatment. Registration Ethical committee of RWTH Aachen University EK 22-320; Center for Translational & Clinical Research RWTH Aachen University (CTC-A) 21-430.
本研究调查了新冠疫情期间一家儿科创伤中心住院儿童损伤特征的变化。
使用Pearson卡方检验和Mann-Whitney U检验，将2019年疫情前一年受伤儿童的数据与2020年疫情期间的数据进行比较。对高度限制规定时期（HRP）进行了单独评估。通过使用定义的搜索词进行全面的文献综述，得出描述性数据综合结果。
865例患者的数据表明，在HRP期间入院人数减少了5.6%和54.4%。2020年，住院时间更长（2019年为2.2±2.7天，2020年为2.4±2.6天，p = 0.045）；需要手术治疗的伤口比例（p = 0.008）以及主要针对轻度脑损伤的观察性治疗比例（p = 0.046）更高；而主要针对挫伤的保守治疗比例更低（p = 0.005）。年龄、损伤部位或手术治疗频率没有显著变化；HRP期间也没有差异，只是学校和幼儿园的受伤人数较少（p < 0.001）。文献综述总结了79项研究的主要结果。
资源有限并未改变手术治疗的适应症。进一步的研究应探讨在家中更常见的损伤是否是由于父母过度的工作/照顾孩子需求所致。住院保守治疗的减少意味着医院资源可能以前被过度使用。该文献为有关疫情期间儿童损伤及更高效安全治疗的许多详细问题提供了答案。注册 亚琛工业大学伦理委员会EK 22 - 320；亚琛工业大学转化与临床研究中心（CTC - A）21 - 430。
