Pediatr Emerg Med J.  2023 Jan;10(1):17-22. 10.22470/pemj.2022.00563.

Change in pediatric trauma-related visits in a tertiary hospital in Colombia during coronavirus disease 2019 lockdown

Affiliations
  • 1Emergency Department, Clínica Infantil Colsubsidio, Bogotá, Colombia
  • 2Department of Pediatrics, Universidad del Rosario, Bogotá, Colombia
  • 3Department of Pediatrics, Universidad de los Andes, Bogotá, Colombia
  • 4Medical Education and Research Department, Clínica Infantil Colsubsidio, Bogotá, Colombia

Abstract

Purpose
During the coronavirus disease 2019 pandemic, Colombian government declared a lockdown, forcing children to stay at home. The authors aimed to analyze the change in the pattern of trauma-related visits during the lockdown.
Methods
We carried out a retrospective descriptive study on injured children aged 17 years or younger who visited the emergency department of a tertiary pediatric hospital in Bogotá, Colombia from March 15 through May 15, 2019 (control period) and the same period in 2020 (lockdown period). Between the 2 periods, baseline characteristics and injury profiles were compared.
Results
Among the study population (n = 1,485), 1,122 and 363 children visited the emergency department during the control and lockdown periods, respectively. In the midst of 73.9% decrease in numbers of overall visits between the 2 periods, a 67.6% decrease was noted in number of trauma-related visits. Regarding the proportions, trauma-related visits increased from 7.9% to 9.8%. During the lockdown, increases occurred in the proportions of the following variables: children younger than 5 years (25.5% to 50.7%; P < 0.001), mechanisms other than blunt, minor fall or traffic accident (e.g., bite, 3.9% to 6.6%; P = 0.032), child abuse (1.2% to 4.1%; P = 0.003), hospitalization (4.6% to 35.8%; P < 0.001), open wound (21.1% to 36.9%; P < 0.001), the use of computed tomography (6.3% to 9.9%; P < 0.001), and abnormal imaging findings (28.8% to 31.7%; P = 0.003).
Conclusion
During the lockdown, children with trauma may show an increase in overall severity, and also a higher risk of abusive trauma. This finding indicates a sensible need of educating families in prevention of domestic injury.

Keyword

Child; Confined Spaces; COVID-19; Quarantine; Wounds and Injuries

Reference

References

1. Molina Gutiérrez MÁ, Ruiz Domínguez JA, Bueno Barriocanal M, de Miguel Lavisier B, López López R, Martín Sánchez J, et al. Impact of the COVID-19 pandemic on emergency department: early findings from a hospital in Madrid. An Pediatr (Engl Ed). 2020; 93:313–22.
2. Dopfer C, Wetzke M, Zychlinsky Scharff A, Mueller F, Dressler F, Baumann U, et al. COVID-19 related reduction in pediatric emergency healthcare utilization - a concerning trend. BMC Pediatr. 2020; 20:427.
3. Oxford Poverty and Human Development Initiative. Global Multidimensional Poverty Index 2018: the most detailed picture to date of the world’s poorest people. Oxford, UK: University of Oxford;2018. ISBN 978-1-912291-12-0.
4. Mulholland RH, Wood R, Stagg HR, Fischbacher C, Villacampa J, Simpson CR, et al. Impact of COVID-19 on accident and emergency attendances and emergency and planned hospital admissions in Scotland: an interrupted time-series analysis. J R Soc Med. 2020; 113:444–53.
5. Nam DH, Jung SY, Bae S. Changes in pediatric injuryrelated visits during coronavirus disease 2019 pandemic at a single regional emergency medical center in Korea. Pediatr Emerg Med J. 2022; Aug. 16. [Epub]. https://doi.org/10.22470/pemj.2022.00500. Korean.
6. Sheridan GA, Nagle M, Russell S, Varghese S, O’Loughlin PF, Boran S, et al. Pediatric trauma and the COVID-19 pandemic: a 12-year comparison in a level-1 trauma center. HSS J. 2020; 16(Suppl 1):92–6.
7. Chong SL, Soo JS, Allen JC Jr, Ganapathy S, Lee KP, Tyebally A, et al. Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore. BMC Pediatr. 2020; 20:562.
8. Turgut A, Arll H, Altundag˘ Ü, Hanclog˘lu S, Egeli E, Kalenderer Ö. Effect of COVID-19 pandemic on the fracture demographics: data from a tertiary care hospital in Turkey. Acta Orthop Traumatol Turc. 2020; 54:355–63.
9. Claudet I, Marchand-Tonel C, Ricco L, Houzé-Cerfon CH, Lang T, Bréhin C. During the COVID-19 quarantine, home has been more harmful than the virus for children! Pediatr Emerg Care. 2020; 36:e538–40.
10. Bram JT, Johnson MA, Magee LC, Mehta NN, Fazal FZ, Baldwin KD, et al. Where have all the fractures gone? The epidemiology of pediatric fractures during the COVID-19 pandemic. J Pediatr Orthop. 2020; 40:373–9.
11. Keays G, Friedman D, Gagnon I. Injuries in the time of COVID-19. Health Promot Chronic Dis Prev Can. 2020; 40:336–41.
12. Hamill JK, Sawyer MC. Reduction of childhood trauma during the COVID-19 level 4 lockdown in New Zealand. ANZ J Surg. 2020; 90:1242–3.
13. Garude K, Natalwala I, Hughes B, West C, Bhat W. Patterns of adult and paediatric hand trauma during the COVID-19 lockdown. J Plast Reconstr Aesthet Surg. 2020; 73:1575–92.
14. Dixon CA, Mistry RD. Dog bites in children surge during coronavirus disease-19: a case for enhanced prevention. J Pediatr. 2020; 225:231–2.
15. Sidpra J, Abomeli D, Hameed B, Baker J, Mankad K. Rise in the incidence of abusive head trauma during the COVID-19 pandemic. Arch Dis Child. 2021; 106:e14.
16. Hatchimonji JS, Swendiman RA, Seamon MJ, Nance ML. Trauma does not quarantine: violence during the COVID-19 pandemic. Ann Surg. 2020; 272:e53–4.
17. Pintado JF, Gibaja W, Vallejos RA, Rosas W, Guerra-Farfan E, Nuñez JH. How COVID-19 has affected emergent visits to a Latin-American trauma department: experience at a Peruvian national trauma referral center. Injury. 2020; 51:2834–9.
Full Text Links
  • PEMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr