Injury Patterns and Outcomes at a Single Pediatric Trauma Center During the Coronavirus Disease 19 Pandemic

Travis M Sullivan; Daniel Scheese; Eisha Jain; Zachary P Milestone; Jeffrey Haynes; Laura A Boomer

doi:10.1016/j.jss.2023.06.003

Injury Patterns and Outcomes at a Single Pediatric Trauma Center During the Coronavirus Disease 19 Pandemic

J Surg Res. 2023 Dec:292:123-129. doi: 10.1016/j.jss.2023.06.003. Epub 2023 Jun 22.

Authors

Travis M Sullivan¹, Daniel Scheese¹, Eisha Jain², Zachary P Milestone³, Jeffrey Haynes⁴, Laura A Boomer⁵

Affiliations

¹ Department of Surgery, Virginia Commonwealth University Health System, Richmond, Virginia.
² Virginia Commonwealth University School of Medicine, Richmond, Virginia.
³ Mount Sinai School of Medicine, New York, New York.
⁴ Division of Pediatric Surgery, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.
⁵ Division of Pediatric Surgery, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia. Electronic address: laura.boomer@vcuhealth.org.

Abstract

Introduction: The coronavirus disease 19 (COVID-19) pandemic is reported to have changed injury patterns, prevalence, and outcomes across multiple institutions in the United States. Interpretation of aggregate data is difficult because injury patterns vary between urban and rural hospitals and the implementation of locoregional public health policies and guidelines in response to COVID-19 differed. To prepare our trauma system for future societal shutdowns, we compared injury patterns and outcomes of injured children and adolescents at a single pediatric trauma center before and during the first 2 y of the COVID-19 pandemic.

Methods: We abstracted demographic, injury, and outcome data for injured children and adolescents (age <15 y) who required admission using our hospital trauma registry and the electronic medical record. We compared differences prior to and during the COVID-19 pandemic using univariate analysis. To address confounding variables, we also analyzed in-hospital mortality using a multivariable regression.

Results: We observed an increase in the number of injured children requiring admission during the first year of the COVID-19 pandemic compared to the prepandemic era. Among injury types sustained, we observed an increase in firearm and nonfirearm related penetrating injuries (P < 0.001) during the first year, but not the second year, of the COVID-19 pandemic. Controlling for several confounding variables, we also observed an increase in in-hospital mortality (P = 0.04) during the first year of the COVID-19 pandemic.

Conclusions: The psychosocial and socioeconomic burden of the COVID-19 pandemic may have contributed to the rise in penetrating injuries and the odds of in-hospital mortality among a cohort of children and adolescents who were admitted to our hospital following injury. This data may be used to prepare our trauma system for future societal shutdowns through data informed resource utilization.

Keywords: COVID-19; Pediatrics; Wounds and injuries.