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Impact of “Stay-at-Home”Orders on Non-accidental Trauma: A Multi-institutional Study
Pediatrics ; 149, 2022.
Article in English | EMBASE | ID: covidwho-2003063
ABSTRACT

Background:

In response to the COVID-19 pandemic, local and regional Stay-at-Home orders (SHO) were implemented. Families experienced job loss, financial strain, and children were unable to attend school. It is unclear how this combination of events and social stress affected the welfare of children and rates of pediatric injury nationwide. We hypothesized that the rate of non-accidental trauma (NAT) would increase during the SHO as children did not have access to mandatory reporters, such as schoolteachers and primary care physicians.

Methods:

A multi-center, retrospective study was conducted evaluating patients <18 years old with traumatic injuries as defined by National Trauma Data Bank. Patients with ICD-10 Diagnosis and/or External Cause of Injury codes meeting criteria for NAT were included. “Historical” controls from an averaged period of March-September 2016-2019 were compared to patients injured after the implementation of SHO through September 2020 (“COVID” cohort). SHO were defined at the state level for each site. An interrupted time series analysis was utilized to evaluate the effect of the implementation of SHO.

Results:

A total of 9 Level I pediatric trauma centers were included, contributing 39,331 pediatric trauma patients, of which 2,064 met criteria for NAT. During the initial SHO, the rate of NAT dropped below what was expected based on the historical trends, however, thereafter the rate increased above the expected rates of NAT [Figure 1]. The COVID cohort experienced a significant increase in the proportion of NAT patients age >5 years (Historical 36 patients [13.5%] vs. COVID 103 patients [30.8%], p<0.001). Ultimately, 2020 experienced an increased cumulative burden of NAT cases as reported to institutional trauma registries when compared to the Historical cohort [Figure 2].

Conclusion:

The COVID-19 pandemic affected the presentation of children with NAT to the hospital. For school-aged children sequestered at home by the pandemic, increased NAT may reflect the absence of normal safeguards provided by the educational system, potentially leaving a vulnerable population at risk. Particularly in times of public health crisis, maintaining systems of protection for children remains essential.
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Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Pediatrics Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Pediatrics Year: 2022 Document Type: Article