Kazemi Foad, Liu Jiaqi, Nasr Isam W, Chidiac Charbel, Robinson Shenandoah, Cohen Alan R
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Pediatr Res. 2025 Mar 24. doi: 10.1038/s41390-025-03996-0.
The COVID-19 pandemic intensified psychosocial stressors, potentially contributing to increased rates of child abuse. This study aimed to compare trends in child abuse/traumatic brain injury (TBI) admissions and socioeconomic status before and after the pandemic.
A 7-year retrospective study was conducted at a Level-1 Pediatric Trauma Center. TBI cases were identified using ICD-10 codes based on the modified CDC framework. Neighborhood disadvantage and injury severity were measured using the Social Deprivation Index (SDI) and Injury Severity Score (ISS), respectively, with higher scores indicating greater disadvantage and severity. A Bayesian structural time series (BSTS) model was employed to assess the causal impact of COVID-19 on monthly child abuse/TBI admissions, SDI, and ISS.
The study included 560 child abuse cases, with 62.3% involving TBI. Before COVID-19, monthly admissions averaged 5.89 for child abuse and 3.70 for child abuse with TBI, with corresponding SDI scores of 60.07 and 57.60. During the COVID era, monthly averages rose to 8.77 and 5.58 (p = 0.001, p < 0.001), and SDI scores increased to 66.32 and 61.60 (p = 0.053, p = 0.370). BSTS analysis inferred a causal impact of COVID-19 on monthly child abuse admissions (p = 0.001), monthly child abuse admissions sustaining TBI (p = 0.001), an upward trend in average monthly SDI scores (p = 0.033), and a decrease in average monthly ISS (p = 0.001).
The study indicates a significant increase in child abuse/TBI admissions and heightened neighborhood disadvantage during the COVID-19 pandemic.
This study uses Bayesian structural time series analysis to assess the COVID-19 pandemic's causal impact on child abuse and traumatic brain injury (TBI) admissions. The pandemic is linked to increased child abuse admissions and TBI cases, correlating with worsening socioeconomic conditions indicated by higher Social Deprivation Index scores. Admissions did not rise significantly during the early pandemic (first 3 months, p = 0.160), but mid-to-late phases showed a significant increase (p = 0.001). Injury severity, as measured by Injury Severity Score, declined, suggesting less severe injuries during the pandemic. These findings emphasize the need for proactive interventions and continuous surveillance to protect vulnerable populations.
新冠疫情加剧了社会心理压力源，可能导致虐待儿童发生率上升。本研究旨在比较疫情前后虐待儿童/创伤性脑损伤（TBI）入院率及社会经济状况的趋势。
在一家一级儿科创伤中心进行了一项为期7年的回顾性研究。根据修改后的美国疾病控制与预防中心框架，使用国际疾病分类第10版代码识别TBI病例。分别使用社会剥夺指数（SDI）和损伤严重程度评分（ISS）衡量社区劣势和损伤严重程度，分数越高表明劣势和严重程度越大。采用贝叶斯结构时间序列（BSTS）模型评估新冠疫情对每月虐待儿童/TBI入院率、SDI和ISS的因果影响。
该研究纳入了560例虐待儿童病例，其中62.3%涉及TBI。在新冠疫情之前，每月虐待儿童的入院平均人数为5.89例，伴有TBI的虐待儿童入院平均人数为3.70例，相应的SDI分数分别为60.07和57.60。在新冠疫情期间，每月平均值分别升至8.77和5.58（p = 0.001，p < 0.001），SDI分数分别增至66.32和61.60（p = 0.053，p = 0.370）。BSTS分析推断新冠疫情对每月虐待儿童入院率（p = 0.001）、伴有TBI的每月虐待儿童入院率（p = 0.001）、每月平均SDI分数的上升趋势（p = 0.033）以及每月平均ISS的下降（p = 0.001）存在因果影响。
该研究表明，在新冠疫情期间，虐待儿童/TBI入院率显著上升，社区劣势加剧。
本研究使用贝叶斯结构时间序列分析评估新冠疫情对虐待儿童和创伤性脑损伤（TBI）入院率的因果影响。疫情与虐待儿童入院率和TBI病例增加有关，这与社会剥夺指数得分升高所表明的社会经济状况恶化相关。在疫情早期（前3个月，p = 0.160）入院人数没有显著上升，但在疫情中后期出现了显著增加（p = 0.001）。用损伤严重程度评分衡量的损伤严重程度有所下降，表明疫情期间受伤程度较轻。这些发现强调了采取积极干预措施和持续监测以保护弱势群体的必要性。
