324 - The Effects of COVID-19 on Emergency Department Visits for Pediatric Pedestrian Crashes: A Multi-Center Retrospective Study

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 324
Publication Number: 324.42

Lindsay Clukies, Washington University in St. Louis School of Medicine, Frontenac, MO, United States; Kathryn A. Spectorsky, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Holly R. Hanson, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States; Wendy J. MD, Cincinnati Children's Hospital, Cincinnati, OH, United States; Maneesha Agarwal, Children's Healthcare of Atlanta / Emory University School of Medicine, Atlanta, GA, United States; Tanya Charyk Stewart, London Health Sciences Centre & Western University, London, ON, Canada; Puja Desai, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Zoabe Hafeez, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States

Presenting Author(s)

Lindsay Clukies, MD (she/her/hers)

Assistant Professor of Pediatrics, Associate Trauma Medical Director
Washington University in St. Louis School of Medicine
Frontenac, Missouri, United States

Background:

There has been an unprecedented 55% increase in pedestrian deaths from 2009 to 2018, with children among the most vulnerable populations. The COVID-19 pandemic was associated with changes in traffic patterns and affected daily routines involving childcare, school, and work. While other potential variables may have impacted the rate of pediatric pedestrian crashes, the true impact on pediatric pedestrian injury across the United States remains unclear.

Objective:

To describe the prevalence of pediatric emergency department (PED) visits for pedestrian crashes overall, as well as compare regional, demographic, temporal and socioeconomic variations prior to and during the COVID-19 pandemic.

Design/Methods:

Pedestrian injuries from a multicenter, cross-sectional study of PED injury-related visits from children < 18 years old from January 2019 through December 2020 were examined. Pedestrian injury was defined by at least one International Classification of Disease (ICD) 10th revision code for bodily injury (S00 - T78), as the result of traffic or non-traffic motor vehicle collision (MVC) with a pedestrian (V02-09 codes). Descriptive statistics were calculated and data from before (defined as March – December 2019) and during (defined as March-December 2020) the COVID-19 pandemic time periods were compared utilizing chi-square and t-tests.

Results:

Of the 589,083 total injury visits during the study dates, 2,661 (4.5%) accounted for pedestrian injuries, with 1,569/341,242 (4.6%) before and 1,092/247,841 (4.4%) during the COVID-19 pandemic. During the pandemic children with pedestrian injuries were younger (p< 0.0042), more likely white (p< 0.0001) and with private insurance (p=0.0247) than those injured pre-pandemic (table 1). In addition, there was a lower deprivation index during the pandemic indicating higher socioeconomic status (p=0.0015). More injuries occurred in the South compared to other regions (p< 0.0001). During the pandemic, more patients were triaged as needing immediate or emergent care (p=0.0086), but there was no difference in admission or death rates, types of injuries, or injured body regions (table 2).

Conclusion(s):

There was no change in the prevalence of PED visits for pedestrian crashes during the pandemic compared to pre-pandemic. While patients were noted to be triaged at higher acuities, there was no difference in disposition or injury patterns. In addition, significant racial, geographic and socioeconomic differences were noted. This data can help better prepare for injury prevention initiatives during future pandemics.