The Effect of Covid-19 Pandemic on Computed Tomography Evaluations in Pediatric Emergency Traumas

Abstract

Objective: The aim of this study was to compare the number of computed tomography (CT) examinations and pathologies of the pediatric patients admitted to the emergency department due to trauma during the pandemic with the compatible non-pandemic time period.

Matarials and Methods: This study was a retrospective study of the patients aged 0-18 years, who admitted to the emergency department due to trauma and had CT imaging in 1-30 April 2020 and 1-30 April 2019.

Results: In April 2020, 448 patients applied to the emergency department due to trauma. CT scans were performed to 138 of these 448 (30.8%) patients. In April 2019, 2416 patients applied to the emergency department due to trauma. CT scans were performed to 463 of these 2416 (19.1%) patients. No statistically significant difference was found between the patients, who underwent CT in April 2020 and 2019 by gender (p=0.324). A statistically significant difference was found between 2020 and 2019 by the age groups (p<0.001).

Conclusion: This is neither the first nor the last pandemic the world has ever faced. It is very important to determine the differences in patient distribution and to prepare protocols and guidelines to be used during pandemics.

Keywords

• Computed tomography
• pandemic
• pediatric trauma

Covid-19 Pandemisinin Pediatrik Acil Travmalarda Bilgisayarlı Tomografi Değerlendirmelerine Etkisi

Öz

Amaç: Bu çalışmada pandemi sırasında acil servise travma nedeniyle başvuran pediatrik hastaların bilgisayarlı tomografi (BT) tetkik sayılarını ve patolojilerini pandemi olmayan aynı zaman dilimi ile karşılaştırarak pandeminin pediatrik acil travmalara etkisini tartışmayı amaçladık.

Materyal ve Metot: Retrospektif olarak 1-30 Nisan 2020 ve 1-30 Nisan 2019 tarihlerinde hastanemiz acil servisine travma ile başvuran 0-18 yaş arasındaki hastaların tüm BT görüntüleri değerlendirildi.

Bulgular: Nisan 2020’de acil servise travma nedeni ile 0-18 yaşlarında 448 hasta başvurdu ve bu hastaların 138’ine (%30,8) BT çekildi. Nisan 2019’da 2416 hasta başvurdu ve 463 (%19,1) hastaya BT çekildi. Her iki yılda çekilen BT’ler arasında cinsiyete göre bakıldığında anlamlı farklılık saptanmazken (p=0,324) yaş gruplarına göre bakıldığında anlamlı farklılık bulundu (p<0,001).

Sonuç: Bu, dünyanın karşılaştığı ne ilk ne de son pandemidir. Pandemiler esnasında hasta dağılımlarındaki farklılıkları belirleyerek pandemiler esnasında kullanılacak protokoller ve kılavuzlar hazırlamak oldukça önemlidir.

Anahtar Kelimeler

• Bilgisayarlı tomografi
• pandemi
• pediatrik travma

References

1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. doi:10.1016/s0140-6736(20)30183-5
2. Bram JT, Johnson MA, Magee LC, et al. Where have all the fractures gone? The epidemiology of pediatric fractures during the COVID-19 pandemic. J Pediatr Orthop. 2020;40(8):373-379. doi:10.1097/BPO.0000000000001600
3. Walker PA, Harting MT, Baumgartner JE, et al. Modern approaches to pediatric brain injury therapy. J Trauma. 2009;67:120-127. doi:10.1097/TA.0b013e3181ad323a
4. Wintermark M, Sanelli PC, Anzai Y, et al. Imaging evidence and recommendations for traumatic brain injury: advanced neuroand neurovascular imaging techniques. AJNR. 2015;36:1-11. doi:10.3174/ajnr.A4181
5. Miglioretti DL, Johnson E, Williams A, Greenlee TG, et al. The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr. 2013;167:700-707. doi:10.1001/jamapediatrics.2013.311
6. Şimşek P, Gürsoy A. Turkish health care providers views on inappropriate use of emergency department: who, when and why? Int Emerg Nurs. 2015;27:31-36. doi:10.1016/j.ienj.2015.11.004
7. Cao Y, Li Q, Chen J, et al. Hospital emergency management plan during the COVID‐19 epidemic. Acad Emerg Med. 2020;27(4):309-311. doi:10.1111 / acem.13951
8. Giamello JD, Abram S, Bernardi S, et al. The emergency department in the COVID-19 era. Who are we missing? Eur J Emerg Med. 2020;27(4):305-306. doi:10.1097/MEJ.0000000000000718

9. Sheridan GA, Nagle M, Russell S, at al. Pediatric Trauma and the COVID-19 Pandemic: A 12-Year Comparison in a Level-1 Trauma Center. HSSJ. 2020;16:92-96. doi:10.1007/s11420-020-09807-y
10. Nabian MH, Vosoughi F, Najafib F, at al. Epidemiological pattern of pediatric trauma in COVID-19 outbreak: Data from a tertiary trauma center in Iran. Elsevier Public Health Emergency Collection Injury. 2020;51(12):2811-2815. doi:10.1016/j.injury.2020.09.015
11. Frush DJ, Commander CW, Hartman TS, at al. Utilization of computed tomography imaging in the pediatric emergency department. Pediatric Radiology. 2020;50:470-475. doi:10.1007/s00247-019-04564-5
12. Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;3:1160-1170. doi:10.1016/S0140-6736(09)61558-0
13. Shahi V, Brinjikji W, Cloft HJ, et al. Trends in CT utilization for pediatric fall patients in US emergency departments. Acad Radiol. 2015;22:898-903. doi:10.1016/j.acra.2015.02.016
14. Lodwick DL, Cooper JN, Kelleher KJ, et al. Variation in utilization of computed tomography imaging at tertiary pediatric hospitals. Pediatrics. 2015;136:1212-1219. doi:10.1542/peds.2015-1671
15. Broder J, Fordham LA, Warshauer DM, et al. Increasing utilization of computed tomography in the pediatric emergency department, 2000-2006. Emerg Radiol. 2007;14:227-232. doi:10.1007/s10140-007-0618-9