Abstract
PurposeThe COVID-19 pandemic resulted in increased penetrating trauma and decreased length of stay (LOS) amongst the adult trauma population, findings important for resource allocation. Studies regarding the pediatric trauma population are sparse and mostly single-center. This multicenter study examined pediatric trauma patients, hypothesizing increased penetrating trauma and decreased LOS after the 3/19/2020 stay-at-home (SAH) orders.MethodsA multicenter retrospective analysis of trauma patients ≤ 17 years old presenting to 11 centers in California was performed. Demographic data, injury characteristics, and outcomes were collected. Patients were divided into three groups based on injury date: 3/19/2019–6/30/2019 (CONTROL), 1/1/2020–3/18/2020 (PRE), 3/19/2020–6/30/2020 (POST). POST was compared to PRE and CONTROL in separate analyses.Results1677 patients were identified across all time periods (CONTROL: 631, PRE: 479, POST: 567). POST penetrating trauma rates were not significantly different compared to both PRE (11.3 vs. 9.0%, p = 0.219) and CONTROL (11.3 vs. 8.2%, p = 0.075), respectively. POST had a shorter mean LOS compared to PRE (2.4 vs. 3.3 days, p = 0.002) and CONTROL (2.4 vs. 3.4 days, p = 0.002). POST was also not significantly different than either group regarding intensive care unit (ICU) LOS, ventilator days, and mortality (all p > 0.05).ConclusionsThis multicenter retrospective study demonstrated no difference in penetrating trauma rates among pediatric patients after SAH orders but did identify a shorter LOS.
Highlights
The COVID-19 pandemic resulted in stay-at-home (SAH) orders and other mandates designed to slow the spread of disease [1,2,3]
A total of 1677 trauma patients were identified across the 3 time periods: 631 patients in the control from 3/19/2019–6/30/2019 (CONTROL) group, 479 in the PRE group, and 567 in the POST group
Compared to the CONTROL group, the POST group had a higher rate of Medicaid (46.9 vs. 34.2%, p < 0.001), but lower rates of private insurance (43.0 vs. 57.4%, p < 0.001) and no insurance (3.9 vs. 6.5%, p = 0.043)
Summary
The COVID-19 pandemic resulted in stay-at-home (SAH) orders and other mandates designed to slow the spread of disease [1,2,3] These restrictions triggered business closures, economic losses, and psychological stressors that have significantly impacted society [4,5,6,7,8,9,10,11]. Studies dedicated to the pediatric trauma population are sparse and have been mostly single-center in design [27,28,29,30,31,32,33,34] One of these studies demonstrated a similar increase in pediatric penetrating trauma, as has been seen with adult trauma, during the COVID-19 pandemic [27]. Another study reporting that child-involved shooting incidents increased in 2020 during the COVID-19 pandemic supports the possibility
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