3
|
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. A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic. Inj Epidemiol 2023; 10:66. [PMID: 38093383 PMCID: PMC10717699 DOI: 10.1186/s40621-023-00476-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
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.
Collapse
Affiliation(s)
- Holly R Hanson
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
| | - Margaret Formica
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Danielle Laraque-Arena
- New York Academy of Medicine, New York, New York, USA
- Clinical Epidemiology and Pediatrics, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, Syracuse, NY, USA
| | - Mark R Zonfrillo
- Department of Emergency Medicine, Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, RI, USA
| | - Puja Desai
- Department of Pediatrics, St. Louis Children's Hospital and Washington University School of Medicine, St. Louis, MO, USA
| | - Joseph O O'Neil
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Purnima Unni
- Department of Pediatric Trauma, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Estell Lenita Johnson
- Department of Epidemiology, School of Public Health, Injury Free Coalition for Kids, Columbia University, New York City, NY, USA
| | - Patricia Cobb
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Maneesha Agarwal
- Department of Pediatrics and Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Kristen Beckworth
- Center for Childhood Injury Prevention, Texas Children's Hospital, Houston, TX, USA
| | - Stephanie Schroter
- Department of Pediatric Emergency Medicine, University of California, Rady Children's Hospital San Diego, San Diego, CA, USA
| | - Stephen Strotmeyer
- Department of Pediatric General and Thoracic Surgery, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
- Allegheny County Health Department, Pittsburgh, PA, USA
| | - Katie A Donnelly
- Division of Emergency Medicine, Children's National Hospital, Washington, DC, USA
| | - Leah K Middelberg
- Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Amber M Morse
- Division of Pediatric Emergency Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, USA
| | | | - Richard F Latuska
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Brit Anderson
- Department of Pediatric Emergency Medicine, Norton Children's Hospital, Louisville, KY, USA
| | - Karla A Lawson
- Trauma and Injury Research Center, Dell Children's Medical Center of Central Texas, Austin, TX, USA
| | - Michael Valente
- Department of Pediatric Emergency Medicine, Children's Health Orange County, Orange, CA, USA
| | - Michael N Levas
- Department of Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andrew Waititu Kiragu
- Department of Pediatrics, University of Minnesota and Children's Minnesota, Minneapolis, MN, USA
| | - Kathy Monroe
- Division of Pediatric Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephanie M Ruest
- Department of Emergency Medicine, Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, RI, USA
| | - Lois K Lee
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Tanya Charyk Stewart
- Department of Paediatrics, University of Western Ontario and London Health Sciences Centre, London, ON, Canada
| | - Megan M Attridge
- Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Maya Haasz
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mubeen Jafri
- Department of Pediatric Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Alicia McIntire
- Department of Pediatric Surgery, Randall Children's Hospital at Emanuel Legacy, Portland, OR, USA
| | - Steven C Rogers
- Department of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Hospital, Hartford, CT, USA
| | - Neil G Uspal
- Division of Emergency Medicine, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - Ashley Blanchard
- Department of Emergency Medicine, Columbia University Medical Center, New York City, NY, USA
| | - Max D Hazeltine
- Department of Surgery, UMass Chan Medical School, Worcester, MA, USA
| | - Teresa Riech
- Department of Pediatric Emergency Medicine, OSF Saint Francis Medical Center, Peoria, IL, USA
| | - Charles Jennissen
- Department of Pediatrics, Roy J. and Lucille A. Carter College of Medicine, University of Iowa, Iowa City, IA, USA
- Department of Emergency Medicine, Roy J. and Lucille A. Carter College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Lynn Model
- Department of Pediatric Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Quinney Fu
- Division of Emergency Medicine, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Lindsay D Clukies
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA
| | - David Juang
- Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, MO, USA
| | - Michelle T Ruda
- Department of Pediatrics, Children's Memorial Hermann Hospital, UTHealth Houston, Houston, TX, USA
| | - Jose M Prince
- Department of Pediatric Surgery, Northwell Health, New Hyde Park, NY, USA
| | - Stephanie Chao
- Division of Pediatric Surgery, Stanford School of Medicine, Palo Alto, CA, USA
| | - Brian K Yorkgitis
- Department of Surgery, University of FL College of Medicine - Jacksonville, Jacksonville, FL, USA
| | - Wendy J Pomerantz
- Division of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
4
|
Vanderloo LM, Saravanamuttoo K, Bourke M, Zhong S, Szpunar M, Gilliland J, Burke SM, Irwin JD, Truelove S, Tucker P. Parents' attitudes regarding their children's play during COVID-19: Impact of socioeconomic status and urbanicity. SSM Popul Health 2023; 24:101549. [PMID: 38021457 PMCID: PMC10661847 DOI: 10.1016/j.ssmph.2023.101549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/17/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. This study explored the influence of socioeconomic status (SES) and urbanicity on parents' attitudes toward their children's active play opportunities 6 months and 1.5 years into COVID-19. Methods A sample of 239 Ontario parents of children aged 12 and younger completed two online surveys (August-December 2020; 2021) to assess parents' intentions, beliefs, and comforts concerning their child's eventual return to play, in addition to various sociodemographic and physical activity variables. Descriptive analyses were run as well as an exploratory factor analysis (EFA) was conducted to group the 14 attitude items into subscales for analysis, to ensure reliability and validity of attitude measures. Results In general, parents in communities with more urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents with lower-incomes were more hesitant to return their children to active play during the pandemic. Conclusion Findings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.
Collapse
Affiliation(s)
- Leigh M. Vanderloo
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Elborn College, 1201 Western Road, Room 2547, London, ON, N6G 1H1, Canada
- ParticipACTION, 77 Bloor Street West, Suite 1205, Toronto, ON, M5S 1M2, Canada
| | - Kendall Saravanamuttoo
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, ON, N6A 5B9, Canada
| | - Matthew Bourke
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Elborn College, 1201 Western Road, Room 2547, London, ON, N6G 1H1, Canada
| | - Shiran Zhong
- Department of Geography and Environment, University of Western Ontario, London, ON, N6G 1H1, Canada
| | - Monika Szpunar
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, University of Western Ontario, London, ON, N6A 5B9, Canada
| | - Jason Gilliland
- Department of Geography and Environment, University of Western Ontario, London, ON, N6G 1H1, Canada
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, N6C 2R5, Canada
- Department of Pediatrics, University of Western Ontario, London, ON, N6G 1H1, Canada
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, ON, N6G 1H1, Canada
| | - Shauna M. Burke
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, N6C 2R5, Canada
| | - Jennifer D. Irwin
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
| | - Stephanie Truelove
- Member Interest Groups Section, Professional Development and Practice Support, College of Family Physicians of Canada, Mississauga, ON, L4W 5A4, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Elborn College, 1201 Western Road, Room 2547, London, ON, N6G 1H1, Canada
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, N6C 2R5, Canada
| |
Collapse
|
6
|
Abed V, Hawk GS, Akarakian R, Stone AV. Epidemiological analysis of concussions in youth ice hockey players: A national emergency room database study. Am J Emerg Med 2023; 67:130-134. [PMID: 36871481 DOI: 10.1016/j.ajem.2023.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
PURPOSE To evaluate the epidemiology of concussions in youth ice hockey players. METHODS The National Electronic Injury Surveillance System (NEISS) database was used to gather data. Concussions occurring during ice hockey participation in youth patients (4-21 years old) from 2012 to 2021 was gathered. Concussion mechanisms were grouped into 7 categories: head-to-player, head-to-puck, head-to-ice, head-to-board/glass, head-to-stick, head-to-goal post, and unknown. Hospitalization rates were also tabulated. Linear regression models were used to assess changes in yearly concussion and hospitalization rates over the study period. Results from these models were reported using parameter estimates [with 95% confidence intervals (CI)] and the estimated Pearson correlation coefficient. Additionally, logistic regression was used to model the risk of hospitalization across the different cause categories. RESULTS A total of 819 ice hockey related concussions were analyzed between 2012 and 2021. The average age of our cohort was 13.4 years, with 89.3% (n = 731) of concussions occurring in males. The incidence of head-to-ice, head-to-board/glass, head-to-player, and head-to-puck concussion mechanisms decreased significantly over the study period (slope estimate = -2.1 concussions/year [CI: (-3.9, -0.2)], r = -0.675, p = 0.032), (slope estimate = -2.7 concussions/year [CI: (-4.3, -1.2)], r = -0.816, p = 0.004), (slope estimate = -2.2 concussions/year [CI: (-3.4, -1.0)], r = -0.832, p = 0.003), and (slope estimate = -0.4 concussions/year [CI: (-0.62, -0.09)], r = -0.768, p = 0.016), respectively. Majority of patients were discharged from the emergency department (ED) to their home, as only 20 people (2.4%) were hospitalized over our study period. The majority of concussions were due to head-to-ice (n = 285, 34.8%), followed by head-to-board/glass (n = 217, 26.5%) and head-to-player (n = 207, 25.3%). The most common cause for hospitalizations due to concussions was head-to-board/glass (n = 7, 35%), followed by head-to-player (n = 6, 30%) and head-to-ice (n = 5, 25%). CONCLUSION The most common mechanism of youth ice hockey concussions was head-to-ice in our 10-year study period, while head-to-board/glass was the most common cause of hospitalizations. IRB: This project did not require review by the institutional review board.
Collapse
Affiliation(s)
- Varag Abed
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, United States of America.
| | - Gregory S Hawk
- Department of Statistics, University of Kentucky, United States of America.
| | - Roy Akarakian
- Department of Emergency Medicine, Keck School of Medicine of USC, United States of America.
| | - Austin V Stone
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, United States of America.
| |
Collapse
|