Injury-Related Pediatric Emergency Department Visits in the First Year of COVID-19

Jordee M. Wells, Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
Jonathan Rodean, Children's Hospital Association, Lenexa, KS.
Lawrence Cook, Department of Pediatrics, School of Medicine, The University of Utah, Salt Lake City, UT.
Marion R. Sills, Section of Emergency Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.
Mark I. Neuman, Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Aaron E. Kornblith, Departments of Emergency Medicine & Pediatrics, University of California San Francisco, San Francisco, CA.
Shobhit Jain, Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO.
Alexander W. Hirsch, Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Monika K. Goyal, Department of Pediatrics, Children's National Hospital, The George Washington University, Washington, DC.
Eric W. Fleegler, Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Amy M. DeLaroche, Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI.
Paul L. Aronson, Departments of Pediatrics and of Emergency Medicine, Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, CT.
Julie C. Leonard, Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.

Document Type

Journal Article

Publication Date

7-15-2022

Journal

Pediatrics

DOI

10.1542/peds.2021-054545

Abstract

OBJECTIVE: To describe the epidemiology of pediatric injury-related visits to children's hospital emergency departments (EDs) in the United States (US) during early and later periods of the SARS-CoV-2 pandemic. STUDY DESIGN: We conducted a cross-sectional study using the Pediatric Health Information System, an administrative database to identify injury-related ED visits at 41 US children's hospitals during the SARS-CoV-2 pandemic period (March 15, 2020 to March 14, 2021) and a 3-year comparator period (March 15-March 14, 2017-2020). For these two periods, we compared patient characteristics, injury type and severity, primary discharge diagnoses, and disposition, stratified by early (March 15, 2020 to June 30, 2020), middle (July 1, 2020 to Oct 31, 2020), and late (November 1, 2020 to March 14, 2021) pandemic periods. RESULTS: Overall, ED injury-related visits decreased by 26.6% during the first year of the SARS-CoV-2 pandemic, with the largest decline observed in minor injuries. ED injury-related visits resulting in serious-critical injuries increased across the pandemic (15.9% early, 4.9% middle, 20.6% late). Injury patterns with the sharpest relative declines included superficial injuries (41.7% early) and sprains/strains (62.4% early). Mechanisms of injury with the greatest relative increases included (1) firearms (22.9% early, 42.8% middle, 37% late); (2) pedal cyclists (60.4%, 24.9%, 32.2%); (3) other transportation (20.8%, 25.3%, 17.9%); and (4) suffocation/asphyxiation (21.4%, 20.2%, 28.4%) and injuries due to suicide intent (-16.2%, 19.9%, 21.8%). CONCLUSIONS: Pediatric injury-related ED visits declined in general. However, there was a relative increase in injuries with the highest severity, which warrants further investigation.

Department

Pediatrics

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