Location
Philadelphia, PA
Start Date
3-5-2023 1:00 PM
End Date
3-5-2023 4:00 PM
Description
Introduction: Social determinants of health (SDOH) affect pediatric injury patterns as vulnerable populations are likely to experience more frequent or severe injuries. This study evaluates the association of COVID-19 and area deprivation with pediatric traumatic injuries.
Methods: We retrospectively evaluated institutional level I pediatric trauma encounters from 1/2018-8/2022. Patients were assessed relative to the U.S. pandemic declaration date (3/11/2020): pre-COVID (<3/11/2020), early post-COVID (3/11/2020-3/11/2021), and late post-COVID (>3/11/2021). The Area Deprivation Index (ADI) measured SDH-related risk at a census block tract group level. Associations between ADI and COVID-19 and injury mechanism and outcomes (intensive care unit [ICU]/ventilator duration, hospital length of stay, and mortality) were assessed using chi-square for categorical and Spearman’s rank correlation for continuous variables.
Results: 4,055 patients were included in the study. There was variability in injury patterns relative to the level of deprivation and the timing of COVID-19. MVCs (12.7% pre vs. 14.3% early post vs. 18.6% late post, p<0.0001) and GSWs (1.2% pre vs. 2.6% early post vs. 2.0% late post, p=0.018) were more common after COVID-19 and more frequently experienced by children with higher deprivation indices. Higher ADI was also associated with worse outcomes (ICU days, r=0.049, p=0.006; ventilator days, r=0.035, p=0.047).
Discussion: Children with vulnerable SDOH status appear to have been disproportionately affected by pediatric traumatic injuries following COVID-19. National-level stressors (COVID-19) impact behaviors on a population level and shift exposure risk to different injury mechanisms. Multi-level public health initiatives are needed to address disparate injury patterns based on SDOH exposure.
Embargo Period
6-28-2023
Included in
Perfect storm? COVID-19, area deprivation, and their association with pediatric trauma
Philadelphia, PA
Introduction: Social determinants of health (SDOH) affect pediatric injury patterns as vulnerable populations are likely to experience more frequent or severe injuries. This study evaluates the association of COVID-19 and area deprivation with pediatric traumatic injuries.
Methods: We retrospectively evaluated institutional level I pediatric trauma encounters from 1/2018-8/2022. Patients were assessed relative to the U.S. pandemic declaration date (3/11/2020): pre-COVID (<3/11/2020), early post-COVID (3/11/2020-3/11/2021), and late post-COVID (>3/11/2021). The Area Deprivation Index (ADI) measured SDH-related risk at a census block tract group level. Associations between ADI and COVID-19 and injury mechanism and outcomes (intensive care unit [ICU]/ventilator duration, hospital length of stay, and mortality) were assessed using chi-square for categorical and Spearman’s rank correlation for continuous variables.
Results: 4,055 patients were included in the study. There was variability in injury patterns relative to the level of deprivation and the timing of COVID-19. MVCs (12.7% pre vs. 14.3% early post vs. 18.6% late post, p<0.0001) and GSWs (1.2% pre vs. 2.6% early post vs. 2.0% late post, p=0.018) were more common after COVID-19 and more frequently experienced by children with higher deprivation indices. Higher ADI was also associated with worse outcomes (ICU days, r=0.049, p=0.006; ventilator days, r=0.035, p=0.047).
Discussion: Children with vulnerable SDOH status appear to have been disproportionately affected by pediatric traumatic injuries following COVID-19. National-level stressors (COVID-19) impact behaviors on a population level and shift exposure risk to different injury mechanisms. Multi-level public health initiatives are needed to address disparate injury patterns based on SDOH exposure.