A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic

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

doi:10.1186/s40621-023-00476-z

A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic

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. LawsonMichael 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

Surgery

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English (US)
Article number	66
Journal	Injury Epidemiology
Volume	10
Issue number	1
DOIs	https://doi.org/10.1186/s40621-023-00476-z
State	Published - Dec 2023

Keywords

Disparities
Emergency department
Injuries
Injury prevention
Pandemic
Pediatrics

ASJC Scopus subject areas

General Medicine

Access to Document

10.1186/s40621-023-00476-z

Cite this

Hanson, H. R., Formica, M., Laraque-Arena, D., Zonfrillo, M. R., Desai, P., O’Neil, J. O., Unni, P., Johnson, E. L., Cobb, P., Agarwal, M., Beckworth, K., Schroter, S., Strotmeyer, S., Donnelly, K. A., Middelberg, L. K., Morse, A. M., Dodington, J., Latuska, R. F., Anderson, B., ... Pomerantz, W. J. (2023). A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic. Injury Epidemiology, 10(1), Article 66. https://doi.org/10.1186/s40621-023-00476-z

Hanson, HR, Formica, M, Laraque-Arena, D, Zonfrillo, MR, Desai, P, O’Neil, JO, Unni, P, Johnson, EL, Cobb, P, Agarwal, M, Beckworth, K, Schroter, S, Strotmeyer, S, Donnelly, KA, Middelberg, LK, Morse, AM, Dodington, J, Latuska, RF, Anderson, B, Lawson, KA, Valente, M, Levas, MN, Kiragu, AW, Monroe, K, Ruest, SM, Lee, LK, Charyk Stewart, T, Attridge, MM, Haasz, M, Jafri, M, McIntire, A, Rogers, SC, Uspal, NG, Blanchard, A, Hazeltine, MD, Riech, T, Jennissen, C, Model, L, Fu, Q, Clukies, LD, Juang, D, Ruda, MT, Prince, JM, Chao, S, Yorkgitis, BK & Pomerantz, WJ 2023, 'A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic', Injury Epidemiology, vol. 10, no. 1, 66. https://doi.org/10.1186/s40621-023-00476-z

@article{53f37bccf4ff461aa3f0ddeaca2c282d,

title = "A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic",

abstract = "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{\textquoteright}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.",

keywords = "Disparities, Emergency department, Injuries, Injury prevention, Pandemic, Pediatrics",

author = "Hanson, {Holly R.} and Margaret Formica and Danielle Laraque-Arena and Zonfrillo, {Mark R.} and Puja Desai and O{\textquoteright}Neil, {Joseph O.} and Purnima Unni and Johnson, {Estell Lenita} and Patricia Cobb and Maneesha Agarwal and Kristen Beckworth and Stephanie Schroter and Stephen Strotmeyer and Donnelly, {Katie A.} and Middelberg, {Leah K.} and Morse, {Amber M.} and James Dodington and Latuska, {Richard F.} and Brit Anderson and Lawson, {Karla A.} and Michael Valente and Levas, {Michael N.} and Kiragu, {Andrew Waititu} and Kathy Monroe and Ruest, {Stephanie M.} and Lee, {Lois K.} and {Charyk Stewart}, Tanya and Attridge, {Megan M.} and Maya Haasz and Mubeen Jafri and Alicia McIntire and Rogers, {Steven C.} and Uspal, {Neil G.} and Ashley Blanchard and Hazeltine, {Max D.} and Teresa Riech and Charles Jennissen and Lynn Model and Quinney Fu and Clukies, {Lindsay D.} and David Juang and Ruda, {Michelle T.} and Prince, {Jose M.} and Stephanie Chao and Yorkgitis, {Brian K.} and Pomerantz, {Wendy J.}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = dec,

doi = "10.1186/s40621-023-00476-z",

language = "English (US)",

volume = "10",

journal = "Injury Epidemiology",

issn = "2197-1714",

publisher = "SpringerOpen",

number = "1",

}

TY - JOUR

T1 - A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic

AU - Hanson, Holly R.

AU - Formica, Margaret

AU - Laraque-Arena, Danielle

AU - Zonfrillo, Mark R.

AU - Desai, Puja

AU - O’Neil, Joseph O.

AU - Unni, Purnima

AU - Johnson, Estell Lenita

AU - Cobb, Patricia

AU - Agarwal, Maneesha

AU - Beckworth, Kristen

AU - Schroter, Stephanie

AU - Strotmeyer, Stephen

AU - Donnelly, Katie A.

AU - Middelberg, Leah K.

AU - Morse, Amber M.

AU - Dodington, James

AU - Latuska, Richard F.

AU - Anderson, Brit

AU - Lawson, Karla A.

AU - Valente, Michael

AU - Levas, Michael N.

AU - Kiragu, Andrew Waititu

AU - Monroe, Kathy

AU - Ruest, Stephanie M.

AU - Lee, Lois K.

AU - Charyk Stewart, Tanya

AU - Attridge, Megan M.

AU - Haasz, Maya

AU - Jafri, Mubeen

AU - McIntire, Alicia

AU - Rogers, Steven C.

AU - Uspal, Neil G.

AU - Blanchard, Ashley

AU - Hazeltine, Max D.

AU - Riech, Teresa

AU - Jennissen, Charles

AU - Model, Lynn

AU - Fu, Quinney

AU - Clukies, Lindsay D.

AU - Juang, David

AU - Ruda, Michelle T.

AU - Prince, Jose M.

AU - Chao, Stephanie

AU - Yorkgitis, Brian K.

AU - Pomerantz, Wendy J.

PY - 2023/12

Y1 - 2023/12

N2 - 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.

AB - 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.

KW - Disparities

KW - Emergency department

KW - Injuries

KW - Injury prevention

KW - Pandemic

KW - Pediatrics

UR - http://www.scopus.com/inward/record.url?scp=85179623082&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85179623082&partnerID=8YFLogxK

U2 - 10.1186/s40621-023-00476-z

DO - 10.1186/s40621-023-00476-z

M3 - Article

AN - SCOPUS:85179623082

SN - 2197-1714

VL - 10

JO - Injury Epidemiology

JF - Injury Epidemiology

IS - 1

M1 - 66

ER -

A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this