O2077: Pediatric Emergency Injuries Increase in Severity During the Pandemic

Background: The Covid-19 pandemic and lockdown guidelines have altered human behavioral patterns of everyday life. We sought to investigate general pediatric injury trends and if injury severity changed during the Covid-19 epoch. In our study, we analyzed the effect of types of injuries, products, and injury severity between subgroups divided by age, race, and gender.

Methods: Patterns from before and during the Covid-19 pandemic were compared using the emergency room data reported in the National Electronic Injury Surveillance System (NEISS). This database collects information from a cohort of multiple emergency departments throughout the United States collecting data for injuries involving various products. We decided to utilize a national system, such as the NEISS, in order to observe broader nationwide patterns. Previous national (U.S.) studies evaluating injury trends have been performed using samples from individual institutions or a collection of hospitals within the same region. The NEISS sample is designed to reflect emergency departments throughout the U.S. For pre-Covid-19 data, we used data collected from March to December 2019, while for the Covid-19 era, we used data collected from March through December 2020. Data from NEISS used diagnostic codes as indicators for severity of injury. Mild injuries were coded as those who had no injury or were treated and released. Severe injuries were coded as patients who were treated and transferred, treated and admitted, held for observation, or as fatalities. Unknown injuries were coded as left without being seen or unknown, not stated.

Results: Overall, injuries increased in severity during the pandemic compared to pre-lockdown trends as shown by the two images shared. Before Covid-19, mild injuries constituted 87.24% of total injuries, while severe injuries constituted 11.25% of injuries. During the pandemic, the percentage of mild injuries decreased to 84.67% and the percentage of severe injuries increased to 14.06%.

Conclusion: These findings could have major public safety implications in demonstrating how lockdown procedures could have deterred milder injuries that typically appear in emergency rooms, while pediatric injuries that were more severe in nature and necessitated admission or observation prompted a greater percentage of emergency department visits. The trends could indicate how parents are generally more willing to utilize medical services to maintain the well-being of their children, even with lockdown restrictions in place if the injuries are more severe. As a result, it is important to keep in mind these trends moving forward to monitor if lockdown procedures have an impact on the percentage of mild and severe injuries that result in emergency department visits or if these trends normalize to the data that was available pre-Covid-19.