Neesha S Patel, Brett H Waibel, Bennett J Berning, Wt Hillman Terzian, Charity H Evans, Angela M Hanna, Mark E Hamill
{"title":"Kids gone wild - Alcohol use and patient characteristics in pediatric trauma during the coronavirus disease 2019 pandemic.","authors":"Neesha S Patel, Brett H Waibel, Bennett J Berning, Wt Hillman Terzian, Charity H Evans, Angela M Hanna, Mark E Hamill","doi":"10.1002/ped4.12388","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Reported coronavirus disease 2019 (COVID-19) pandemic effects on pediatric trauma have been variable.</p><p><strong>Objective: </strong>We investigated the characteristics of pediatric trauma including alcohol use during the pandemic at our urban trauma center.</p><p><strong>Methods: </strong>The trauma database of our adult level 1 trauma center was queried for all pediatric (age ≤ 18 years) patients presenting between March 1, 2020, and October 30, 2020. Data from 2017 to 2019 served as a control. Variables analyzed included demographics, mechanisms, injury severity, hospitalization characteristics, and positive blood alcohol.</p><p><strong>Results: </strong>Pandemic pediatric trauma volumes increased by 67.5% (330/year <i>vs</i>. 197/year). Pandemic patients were younger (median age 13 <i>vs</i>. 14 years, <i>P</i> = 0.011), but similar in gender, ethnicity, severity, hospital length of stay, mortality, and rates of penetrating injury. Falls doubled (79/year <i>vs</i>. 34/year) and shifted away from high falls >6 meters (0% <i>vs</i>. 7.9%) to moderate falls 1-6 meters (58.2% <i>vs</i>. 51.5%) (<i>P</i> = 0.028). Transportation injury rates were similar however mechanisms shifted from motor vehicle crashes (-13.5%) towards recreational vehicles including motorcycles (+2.1%), all-terrain vehicles (+8.6%), and bicycles (+3.8%) (<i>P</i> = 0.018). Pediatric-positive blood alcohol was significantly higher (11.2% <i>vs</i>. 5.1%, <i>P</i> < 0.001), especially for ages 14-18 years (21.7% <i>vs</i>. 9.5%, <i>P</i> < 0.001).</p><p><strong>Interpretation: </strong>Pediatric trauma volumes during the COVID-19 pandemic increased. Pandemic patients had more recreational vehicle injuries and higher rates of positive blood alcohol. This suggests an increased need for alcohol assessment and targeted interventions in the pediatric population during pandemics or periods of school closures.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"14 3 1","pages":"225-232"},"PeriodicalIF":3.9000,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693660/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Vascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ped4.12388","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
Importance: Reported coronavirus disease 2019 (COVID-19) pandemic effects on pediatric trauma have been variable.
Objective: We investigated the characteristics of pediatric trauma including alcohol use during the pandemic at our urban trauma center.
Methods: The trauma database of our adult level 1 trauma center was queried for all pediatric (age ≤ 18 years) patients presenting between March 1, 2020, and October 30, 2020. Data from 2017 to 2019 served as a control. Variables analyzed included demographics, mechanisms, injury severity, hospitalization characteristics, and positive blood alcohol.
Results: Pandemic pediatric trauma volumes increased by 67.5% (330/year vs. 197/year). Pandemic patients were younger (median age 13 vs. 14 years, P = 0.011), but similar in gender, ethnicity, severity, hospital length of stay, mortality, and rates of penetrating injury. Falls doubled (79/year vs. 34/year) and shifted away from high falls >6 meters (0% vs. 7.9%) to moderate falls 1-6 meters (58.2% vs. 51.5%) (P = 0.028). Transportation injury rates were similar however mechanisms shifted from motor vehicle crashes (-13.5%) towards recreational vehicles including motorcycles (+2.1%), all-terrain vehicles (+8.6%), and bicycles (+3.8%) (P = 0.018). Pediatric-positive blood alcohol was significantly higher (11.2% vs. 5.1%, P < 0.001), especially for ages 14-18 years (21.7% vs. 9.5%, P < 0.001).
Interpretation: Pediatric trauma volumes during the COVID-19 pandemic increased. Pandemic patients had more recreational vehicle injuries and higher rates of positive blood alcohol. This suggests an increased need for alcohol assessment and targeted interventions in the pediatric population during pandemics or periods of school closures.
期刊介绍:
Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.