70 - The Impact of COVID-19 on Burns Presenting to Pediatric Emergency Departments (EDs)

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 70
Publication Number: 70.112

Stephanie Ruest, Hasbro Children's Hospital at Rhode Island Hospital, Foxboro, MA, United States; Katherine T. Flynn-O'Brien, Medical College of Wisconsin, Milwaukee, WI, United States; Christina Georgeades, Children's Wisconsin, Milwaukee, WI, United States; Holly R. Hanson, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States; Laurie H.. Johnson, Cincinnati Children's Hospital Medical Center, Montgomery, OH, United States; Andrew W.. Kiragu, University of Minnesota/Children's Respiratory & Critical care Specialist's, Minneapolis, MN, United States; Michelle T. Ruda, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Wendy J. MD, Cincinnati Children's Hospital, Cincinnati, OH, United States

Presenting Author(s)

Stephanie Ruest, MD, MPH, FAAP (she/her/hers)

Assistant Professor of Pediatrics and Emergency Medicine
Hasbro Children's Hospital at Rhode Island Hospital
Foxboro, Massachusetts, United States

Background: Fire- and burn-related injuries were the 5^th leading cause of unintentional death in children ages 1-18 in 2019 and 2020, resulting in nearly 150,000 emergency department (ED) visits in the United States in children 0-18 years. Daily life was impacted during the COVID-19 pandemic due to school and daycare closures, cancelled activities, and lockdowns, which likely impacted burn-related injury patterns. To date, no large multi-center studies have been performed to examine changes in pediatric burn injuries occurring during the COVID-19 pandemic.

Objective: To describe changes in burn injury prevalence and patterns among patients treated at 40 pediatric EDs prior to and during the COVID-19 pandemic.

Design/Methods: This is a sub-analysis of data from a multi-center, cross-sectional study from January 2019-December 2020 examining all injury-related visits to 40 pediatric EDs for children < 18 years old. We analyzed ED visits for burns identified by ICD10 codes. We compared ED visits for burns in the study period from 3/17/2019-12/31/2019 to 3/15/2020-12/31/2020, dates corresponding to onset of COVID-19 in 2020 and a similar timeframe in 2019. We calculated frequencies and compared patient demographics, burn prevalence, severity, and mechanisms of injury using Chi-square tests.

Results: During the study period there were 12,908 ED visits for burns, which comprised 2.2% of all injury-related visits, 6,696 in 2019 and 6,212 in 2020. There were 484 (4%) fewer visits for burns in 2020 compared to 2019. However, the proportion of burn-related visits, relative to other injuries, was significantly higher in 2020 than 2019 (2.5% vs. 2.0%, p< 0.0001). As shown in Table 1, there were significant changes in burn-related visits by race (p< 0.003), ethnicity (p = 0.011), and geographic region (p< 0.0001). There were significantly higher proportions of more urgent triage levels, increased trauma activations, and higher mean injury severity scores (Table 2). There were also changes in body region affected (p = 0.0079), intent (p< 0.001) and mechanism (p < 0.0001, Figure 1), with a higher proportion due to flames/fires and fewer due to hot objects (Table 2).

Conclusion(s):

There were fewer burn-injured patients treated during the study period. However, ED visits for burns comprised a higher proportion of all injury-related ED visits during the COVID-19 pandemic compared to 2019, with higher acuity and more severe injuries. There were more burns due to fire/flames and fewer due to hot objects. These results may help inform injury prevention during future pandemics.