对 COVID-19 大流行期间儿科急诊伤害就诊情况的多中心评估。

IF 2.4 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Injury Epidemiology Pub Date : 2023-12-13 DOI:10.1186/s40621-023-00476-z
Holly R Hanson, Margaret Formica, Danielle Laraque-Arena, Mark R Zonfrillo, Puja Desai, Joseph O O'Neil, Purnima Unni, Estell Lenita Johnson, Patricia Cobb, Maneesha Agarwal, Kristen Beckworth, Stephanie Schroter, Stephen Strotmeyer, Katie A Donnelly, Leah K Middelberg, Amber M Morse, James Dodington, Richard F Latuska, Brit Anderson, Karla A Lawson, Michael Valente, Michael N Levas, Andrew Waititu Kiragu, Kathy Monroe, Stephanie M Ruest, Lois K Lee, Tanya Charyk Stewart, Megan M Attridge, Maya Haasz, Mubeen Jafri, Alicia McIntire, Steven C Rogers, Neil G Uspal, Ashley Blanchard, Max D Hazeltine, Teresa Riech, Charles Jennissen, Lynn Model, Quinney Fu, Lindsay D Clukies, David Juang, Michelle T Ruda, Jose M Prince, Stephanie Chao, Brian K Yorkgitis, Wendy J Pomerantz
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引用次数: 0

摘要

背景:伤害是导致 1-17 岁儿童死亡的主要原因,但伤害往往是可以预防的。儿童所处环境的变化、监护方式的转变以及照顾者的压力都会对伤害模式产生影响。本研究的目的是评估 COVID-19 大流行期间儿科急诊室(PED)的伤害发生率和比例、机制和严重程度:这项多中心横断面研究从 2019 年 1 月至 2020 年 12 月对 40 家儿科急诊室的儿童就诊情况进行了调查:研究包括 COVID-19 大流行前(2019 年)和 COVID-19 大流行期间(2020 年)的 741,418 次 PED 伤害就诊。与2019年同期相比,2020年3月至12月期间因各种原因导致的PED就诊人次总体减少了27.4%;但是,2020年与伤害相关的PED就诊人次比例增加了37.7%。2020 年,受伤儿童的年龄更小(中位数年龄为 6.31 岁,而 2019 年为 7.31 岁),更常见的是白人(54% 对 50%,P 结论):与 2019 年同期相比,2020 年 3 月至 12 月与 PED 损伤相关的就诊比例有所上升。种族和付款人存在差异。与 2019 年相比,2020 年期间在 PED 中看到的伤害机制发生了变化,这可以为伤害预防措施提供参考。
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A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic.

Background: Injuries, the leading cause of death in children 1-17 years old, are often preventable. Injury patterns are impacted by changes in the child's environment, shifts in supervision, and caregiver stressors. The objective of this study was to evaluate the incidence and proportion of injuries, mechanisms, and severity seen in Pediatric Emergency Departments (PEDs) during the COVID-19 pandemic.

Methods: This multicenter, cross-sectional study from January 2019 through December 2020 examined visits to 40 PEDs for children < 18 years old. Injury was defined by at least one International Classification of Disease-10th revision (ICD-10) code for bodily injury (S00-T78). The main study outcomes were total and proportion of PED injury-related visits compared to all visits in March through December 2020 and to the same months in 2019. Weekly injury visits as a percentage of total PED visits were calculated for all weeks between January 2019 and December 2020.

Results: The study included 741,418 PED visits for injuries pre-COVID-19 pandemic (2019) and during the COVID-19 pandemic (2020). Overall PED visits from all causes decreased 27.4% in March to December 2020 compared to the same time frame in 2019; however, the proportion of injury-related PED visits in 2020 increased by 37.7%. In 2020, injured children were younger (median age 6.31 years vs 7.31 in 2019), more commonly White (54% vs 50%, p < 0.001), non-Hispanic (72% vs 69%, p < 0.001) and had private insurance (35% vs 32%, p < 0.001). Injury hospitalizations increased 2.2% (p < 0.001) and deaths increased 0.03% (p < 0.001) in 2020 compared to 2019. Mean injury severity score increased (2.2 to 2.4, p < 0.001) between 2019 and 2020. Injuries declined for struck by/against (- 4.9%) and overexertion (- 1.2%) mechanisms. Injuries proportionally increased for pedal cycles (2.8%), cut/pierce (1.5%), motor vehicle occupant (0.9%), other transportation (0.6%), fire/burn (0.5%) and firearms (0.3%) compared to all injuries in 2020 versus 2019.

Conclusions: The proportion of PED injury-related visits in March through December 2020 increased compared to the same months in 2019. Racial and payor differences were noted. Mechanisms of injury seen in the PED during 2020 changed compared to 2019, and this can inform injury prevention initiatives.

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来源期刊
Injury Epidemiology
Injury Epidemiology Medicine-Medicine (all)
CiteScore
3.20
自引率
4.50%
发文量
34
审稿时长
13 weeks
期刊介绍: Injury Epidemiology is dedicated to advancing the scientific foundation for injury prevention and control through timely publication and dissemination of peer-reviewed research. Injury Epidemiology aims to be the premier venue for communicating epidemiologic studies of unintentional and intentional injuries, including, but not limited to, morbidity and mortality from motor vehicle crashes, drug overdose/poisoning, falls, drowning, fires/burns, iatrogenic injury, suicide, homicide, assaults, and abuse. We welcome investigations designed to understand the magnitude, distribution, determinants, causes, prevention, diagnosis, treatment, prognosis, and outcomes of injuries in specific population groups, geographic regions, and environmental settings (e.g., home, workplace, transport, recreation, sports, and urban/rural). Injury Epidemiology has a special focus on studies generating objective and practical knowledge that can be translated into interventions to reduce injury morbidity and mortality on a population level. Priority consideration will be given to manuscripts that feature contemporary theories and concepts, innovative methods, and novel techniques as applied to injury surveillance, risk assessment, development and implementation of effective interventions, and program and policy evaluation.
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