08 October 2021
2 minutes to read
Source / Disclosures
Collings AT, et al. Impact of âstay at homeâ orders on non-accidental trauma: a multi-institutional study. Presented at: AAP National Conference & Exhibition; 8-11 October 2021 (virtual meeting).
Disclosures: The authors do not report any financial disclosures.
The rate of children who presented to nine pediatric trauma centers for non-accidental trauma more than doubled as COVID-19 stay-at-home orders were in place last year, a study found.
The discovery was reported to the AAP National Conference & Exhibition by Catherine T. Flynn-O’Brien, MD, MPH, a pediatric surgeon at the Wisconsin Children’s Hospital in Milwaukee, and colleagues.
In an interview with Healio, Flynn-O’Brien said she saw changes in the “type of injuries” children had as of April 2020.
âAt the start of the pandemic, I just felt empirically as a provider in the hospital that we were seeing a very marked change in the type of pediatric injuries that we were seeing, particularly in the relative proportions of pediatric injuries, between no. intentional and intentional, âsaid Flynn-O’Brien. âAnd so, I really felt like it deserved an investigation. “
Flynn-O’Brien and colleagues included 39,331 pediatric trauma patients from nine Level 1 pediatric trauma centers in the Midwest, including 2,064 who met criteria for non-accidental traumatic injury as defined by the National Trauma Data Bank.
They compared the rate of non-accidental trauma during stay-at-home orders until September 2020 with a monitoring period from March to September during the years 2016 to 2019.
âWe obviously wanted to look at the experience of the pandemic in 2020, and we compared it to a merged cohort, which we call the historic average between 2016 and 2019,â said Flynn-O’Brien. âThe desire was to look at a merged historical cohort rather than a single year so that we could account for any glimpses or anomalies pertaining to a single year. We performed a sensitivity analysis comparing 2020 to 2019 only, to account for temporal variation that may have occurred with things such as referral models, consolidation of trauma care.
In the weeks immediately following the implementation of stay-at-home orders, O’Brien said, the numbers declined.
“It is interesting to note that initially they went down, then about 2 months after the launch of stay-at-home orders, we saw a sharp increase in the cases of child abuse reported in the trauma registers,” Flynn-O’Brien said.
There was a significant increase in the proportion of patients over 5 years of age who presented with non-accidental trauma during the COVID-19 period (30.8%) compared to control years (13.5%), reported reported the researchers.
They said that for school-aged children at home during the pandemic, the increase in reports of non-accidental trauma “may reflect the lack of normal safeguards provided by the education system, potentially leaving a vulnerable population at risk.” .
âWe felt that even during a national crisis like the pandemic, systemic guarantees and typical social services for families are really essential, especially for those who are less wealthy and most vulnerable,â said Flynn-O. ‘Brien.
She said they speculated that people who needed access to social services might not have had it during the pandemic.
“Could that have played a role here?” I think we’ll never know for sure. This data is far too limited to draw a definitive conclusion about it, âsaid Flynn-O’Brien. âGoing forward, in terms of resource allocation and injury prevention, we really need to focus and make sure there’s attention to that. “