Paediatric emergency department during the holidays: Findings from a 10-year analysis of visit rates and trauma patterns

Context: It has been observed that emergency department (ED) visits have been continuously increasing globally and that certain days might affect ED visits and trauma patterns. In previous literature, there is controversy regarding the correlation between paediatric ED (PED) visits and holidays. Aims: To identify the impact of holidays on overall PED visits, trauma rates and characteristics. Settings and Design: This is a retrospective time-series analysis of PED visits and paediatric trauma from 2004 to 2013 conducted in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia. Subjects and Methods: We extracted all ED visits during the 10-year period and included all trauma-related visits recorded in the paediatric trauma registry. The days were marked as holidays or non-holidays. Statistical Analysis Used: SAS Ver. 9.3 was used for analysis. Chi-square test and negative binomial regression were used. Significance was declared at P< 0.05. Results: Holidays were associated with decreased PED visits by 13% compared to non-holidays. Paediatric trauma increased during the holidays by 30%. The highest decrease of PED visits was observed during the summer by 32%. By contrast, during the summer, there was a 56% increase in trauma rates. In Eid A-Fitr, all PED visits decreased by 28%, whereas paediatric trauma increased by 70%. Time of trauma arrival, mechanism of injury, Injury Severity Score and Glasgow coma scale changed significantly during the holidays. Conclusions: Holidays appear to be associated with higher rates of paediatric trauma and fewer overall PED visits. Future work could focus on exploring the reasons behind this change and potential counter measures.