@article{ref1,
title="Effect of the COVID-19 pandemic on presentation and severity of traumatic injury due to physical child abuse across US children's hospitals",
journal="Journal of pediatric surgery",
year="2021",
author="De Boer, Christopher and Ghomrawi, Hassan Mk and Bouchard, Megan E. and Linton, Samuel C. and Tian, Yao and Abdullah, Fizan",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Physical child abuse affects 9 in every 1,000 children in the United States and associated traumatic injuries are often identified by the healthcare system. The COVID-19 pandemic has intensified risk factors for physical child abuse and increased avoidance of the healthcare system. This study examined the effect of the COVID-19 pandemic on presentation and severity of physical child abuse. <br><br>METHODS: A retrospective, cross-sectional study utilizing the Pediatric Health Information System was performed. An interrupted time series analysis estimated the effect of the COVID-19 pandemic on the number of children <15 years old presenting with physical child abuse to children's hospitals from March 1(st) to June 30(th) of 2020 by comparing to those presenting during the same period for years 2016-2019. Hierarchical regression models estimated the effect of the pandemic on likelihood of operative intervention, ICU admission, traumatic brain injury, and mortality. <br><br>RESULTS: Over the study period, 20,346 physical child abuse encounters were reported by 47 children's hospitals. An interrupted times series model predicted a significant decline in cases due to the effect of the COVID-19 pandemic, representing a deficit of 2,645 cases (p = 0.001). Children presenting during the pandemic had increased odds of requiring ICU admission (p = 0.03) and having a traumatic brain injury in those under 5 years of age (p=<0.001). <br><br>CONCLUSIONS: The number of children with physical child abuse presenting to children's hospitals significantly declined during the COVID-19 pandemic, but those that did were more likely to be severe. The pandemic may be a risk factor for worse outcomes associated with physical child abuse.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2021.06.014",
url="http://dx.doi.org/10.1016/j.jpedsurg.2021.06.014"
}