Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study

Yaron Finkelstein; Bryan Maguire; Roger Zemek; Esli Osmanlliu; April J. Kam; Andrew Dixon; Neil Desai; Scott Sawyer; Jason Emsley; Tim Lynch; Ahmed Mater; Suzanne Schuh; Maggie Rumantir; Stephen B. Freedman

doi:10.1097/PEC.0000000000002484

Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study

Yaron Finkelstein, Bryan Maguire, Roger Zemek, Esli Osmanlliu, April J. Kam, Andrew Dixon, Neil Desai, Scott Sawyer, Jason Emsley, Tim Lynch, Ahmed Mater, Suzanne Schuh, Maggie Rumantir, Stephen B. Freedman

Medicine

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

60 Citas (Scopus)

Resumen

Objectives The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. Methods This study is an interrupted-Time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018-January 27, 2020), peripandemic (January 28, 2020-March 10, 2020), and early pandemic (March 11, 2020-April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. Results There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [-58%; 95% confidence interval (CI),-63% to-51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32-1.45] and intensive care unit (OR, 1.20; 95% CI, 1.01-1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45-1.56). Mental health-related visits in children declined in the early-pandemic period (in <10 years,-60%; 95% CI,-67% to-51%; in children ≥10 years:-56%; 95% CI,-63% to-47%) relative to the pre-COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change:-55%; 95% CI,-61% to-49%; P < 0.001). Conclusions After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs.

Idioma original	English
Páginas (desde-hasta)	427-434
Número de páginas	8
Publicación	Pediatric Emergency Care
Volumen	37
N.º	8
DOI	https://doi.org/10.1097/PEC.0000000000002484
Estado	Published - 2021

Nota bibliográfica

Funding Information:
Objectives: The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. Methods: This study is an interrupted-time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018– January 27, 2020), peripandemic (January 28, 2020–March 10, 2020), and early pandemic (March 11, 2020–April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. Results: There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [−58%; 95% confidence interval (CI), −63% to −51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32–1.45] and intensive care unit (OR, 1.20; 95% CI, From the *Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, †Biostatistical Design and Analysis team, The Hospital for Sick Children, University of Toronto, Toronto; ‡Department of Pediatrics and Emergency Medicine, University of Ottawa and Children’s Hospital of Eastern Ontario, Ottawa, Ontario; §Division of Pediatric Emergency Medicine, Montreal Children’s Hospital, McGill University, Montreal, Quebec; ||Department of Pediatrics, Division of Emergency Medicine, McMaster Children’s Hospital, Hamilton, Ontario; ¶Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta; #Division of Pediatric Emergency Medicine, British Columbia Children’s Hospital, Vancouver, British Columbia; **Department of Pediatrics and Emergency Medicine, University of Manitoba, Winnipeg, Manitoba; ††Department of Emergency Medicine, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia; ‡‡Division of Pediatric Emergency Medicine, Department of Pediatrics, Schulich School of Medicine, Western University, London, Ontario; §§Division Pediatric Emergency Medicine, Jim Pattison Children’s Hospital, University of Saskatchewan, Saskatoon, Saskatchewan; ||||Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; and ¶¶Sections of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Disclosure: The authors declare no conflict of interest. Reprints: Stephen Freedman, MDCM, MSc, Alberta Children's Hospital Foundation, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, AB, Canada T3B 6A8 (e‐mail: stephen.freedman@ahs.ca). Dr Stephen Freedman is supported by the Alberta Children’s Hospital Foundation Professorship in Child Health and Wellness. Dr Roger Zemek is supported by a Clinical Research Chair in Pediatric Concussion from University of Ottawa. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.pec-online.com). Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0749-5161 1.01–1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45–1.56). Mental health–related visits in children declined in the early-pandemic period (in <10 years, −60%; 95% CI, −67% to −51%; in children ≥10 years: −56%; 95% CI, −63% to −47%) relative to the pre–COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change: −55%; 95% CI, −61% to −49%; P < 0.001). Conclusions: After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs.

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health
Emergency Medicine

PubMed: MeSH publication types

Journal Article
Observational Study

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

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10.1097/PEC.0000000000002484

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Finkelstein, Y., Maguire, B., Zemek, R., Osmanlliu, E., Kam, A. J., Dixon, A., Desai, N., Sawyer, S., Emsley, J., Lynch, T., Mater, A., Schuh, S., Rumantir, M., & Freedman, S. B. (2021). Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study. Pediatric Emergency Care, 37(8), 427-434. https://doi.org/10.1097/PEC.0000000000002484

Finkelstein, Y, Maguire, B, Zemek, R, Osmanlliu, E, Kam, AJ, Dixon, A, Desai, N, Sawyer, S, Emsley, J, Lynch, T, Mater, A, Schuh, S, Rumantir, M & Freedman, SB 2021, 'Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study', Pediatric Emergency Care, vol. 37, n.º 8, pp. 427-434. https://doi.org/10.1097/PEC.0000000000002484

@article{f88825a1a45049779d25ea0c69a010a0,

title = "Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study",

abstract = "Objectives The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. Methods This study is an interrupted-Time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018-January 27, 2020), peripandemic (January 28, 2020-March 10, 2020), and early pandemic (March 11, 2020-April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. Results There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [-58%; 95% confidence interval (CI),-63% to-51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32-1.45] and intensive care unit (OR, 1.20; 95% CI, 1.01-1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45-1.56). Mental health-related visits in children declined in the early-pandemic period (in <10 years,-60%; 95% CI,-67% to-51%; in children ≥10 years:-56%; 95% CI,-63% to-47%) relative to the pre-COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change:-55%; 95% CI,-61% to-49%; P < 0.001). Conclusions After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs. ",

author = "Yaron Finkelstein and Bryan Maguire and Roger Zemek and Esli Osmanlliu and Kam, {April J.} and Andrew Dixon and Neil Desai and Scott Sawyer and Jason Emsley and Tim Lynch and Ahmed Mater and Suzanne Schuh and Maggie Rumantir and Freedman, {Stephen B.}",

note = "Funding Information: Objectives: The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. Methods: This study is an interrupted-time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018– January 27, 2020), peripandemic (January 28, 2020–March 10, 2020), and early pandemic (March 11, 2020–April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. Results: There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [−58%; 95% confidence interval (CI), −63% to −51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32–1.45] and intensive care unit (OR, 1.20; 95% CI, From the *Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, †Biostatistical Design and Analysis team, The Hospital for Sick Children, University of Toronto, Toronto; ‡Department of Pediatrics and Emergency Medicine, University of Ottawa and Children{\textquoteright}s Hospital of Eastern Ontario, Ottawa, Ontario; §Division of Pediatric Emergency Medicine, Montreal Children{\textquoteright}s Hospital, McGill University, Montreal, Quebec; ||Department of Pediatrics, Division of Emergency Medicine, McMaster Children{\textquoteright}s Hospital, Hamilton, Ontario; ¶Department of Pediatrics, Stollery Children{\textquoteright}s Hospital, University of Alberta, Edmonton, Alberta; #Division of Pediatric Emergency Medicine, British Columbia Children{\textquoteright}s Hospital, Vancouver, British Columbia; **Department of Pediatrics and Emergency Medicine, University of Manitoba, Winnipeg, Manitoba; ††Department of Emergency Medicine, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia; ‡‡Division of Pediatric Emergency Medicine, Department of Pediatrics, Schulich School of Medicine, Western University, London, Ontario; §§Division Pediatric Emergency Medicine, Jim Pattison Children{\textquoteright}s Hospital, University of Saskatchewan, Saskatoon, Saskatchewan; ||||Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; and ¶¶Sections of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children{\textquoteright}s Hospital, Alberta Children{\textquoteright}s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Disclosure: The authors declare no conflict of interest. Reprints: Stephen Freedman, MDCM, MSc, Alberta Children's Hospital Foundation, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, AB, Canada T3B 6A8 (e‐mail: stephen.freedman@ahs.ca). Dr Stephen Freedman is supported by the Alberta Children{\textquoteright}s Hospital Foundation Professorship in Child Health and Wellness. Dr Roger Zemek is supported by a Clinical Research Chair in Pediatric Concussion from University of Ottawa. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal{\textquoteright}s Web site (www.pec-online.com). Copyright {\textcopyright} 2021 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0749-5161 1.01–1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45–1.56). Mental health–related visits in children declined in the early-pandemic period (in <10 years, −60%; 95% CI, −67% to −51%; in children ≥10 years: −56%; 95% CI, −63% to −47%) relative to the pre–COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change: −55%; 95% CI, −61% to −49%; P < 0.001). Conclusions: After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs. Publisher Copyright: {\textcopyright} Wolters Kluwer Health, Inc. All rights reserved.",

year = "2021",

doi = "10.1097/PEC.0000000000002484",

language = "English",

volume = "37",

pages = "427--434",

journal = "Pediatric Emergency Care",

issn = "0749-5161",

publisher = "Lippincott Williams and Wilkins",

number = "8",

}

TY - JOUR

T1 - Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments

T2 - A Nationwide Study

AU - Finkelstein, Yaron

AU - Maguire, Bryan

AU - Zemek, Roger

AU - Osmanlliu, Esli

AU - Kam, April J.

AU - Dixon, Andrew

AU - Desai, Neil

AU - Sawyer, Scott

AU - Emsley, Jason

AU - Lynch, Tim

AU - Mater, Ahmed

AU - Schuh, Suzanne

AU - Rumantir, Maggie

AU - Freedman, Stephen B.

N1 - Funding Information: Objectives: The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. Methods: This study is an interrupted-time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018– January 27, 2020), peripandemic (January 28, 2020–March 10, 2020), and early pandemic (March 11, 2020–April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. Results: There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [−58%; 95% confidence interval (CI), −63% to −51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32–1.45] and intensive care unit (OR, 1.20; 95% CI, From the *Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, †Biostatistical Design and Analysis team, The Hospital for Sick Children, University of Toronto, Toronto; ‡Department of Pediatrics and Emergency Medicine, University of Ottawa and Children’s Hospital of Eastern Ontario, Ottawa, Ontario; §Division of Pediatric Emergency Medicine, Montreal Children’s Hospital, McGill University, Montreal, Quebec; ||Department of Pediatrics, Division of Emergency Medicine, McMaster Children’s Hospital, Hamilton, Ontario; ¶Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta; #Division of Pediatric Emergency Medicine, British Columbia Children’s Hospital, Vancouver, British Columbia; **Department of Pediatrics and Emergency Medicine, University of Manitoba, Winnipeg, Manitoba; ††Department of Emergency Medicine, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia; ‡‡Division of Pediatric Emergency Medicine, Department of Pediatrics, Schulich School of Medicine, Western University, London, Ontario; §§Division Pediatric Emergency Medicine, Jim Pattison Children’s Hospital, University of Saskatchewan, Saskatoon, Saskatchewan; ||||Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; and ¶¶Sections of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Disclosure: The authors declare no conflict of interest. Reprints: Stephen Freedman, MDCM, MSc, Alberta Children's Hospital Foundation, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, AB, Canada T3B 6A8 (e‐mail: stephen.freedman@ahs.ca). Dr Stephen Freedman is supported by the Alberta Children’s Hospital Foundation Professorship in Child Health and Wellness. Dr Roger Zemek is supported by a Clinical Research Chair in Pediatric Concussion from University of Ottawa. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.pec-online.com). Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0749-5161 1.01–1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45–1.56). Mental health–related visits in children declined in the early-pandemic period (in <10 years, −60%; 95% CI, −67% to −51%; in children ≥10 years: −56%; 95% CI, −63% to −47%) relative to the pre–COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change: −55%; 95% CI, −61% to −49%; P < 0.001). Conclusions: After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs. Publisher Copyright: © Wolters Kluwer Health, Inc. All rights reserved.

PY - 2021

Y1 - 2021

N2 - Objectives The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. Methods This study is an interrupted-Time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018-January 27, 2020), peripandemic (January 28, 2020-March 10, 2020), and early pandemic (March 11, 2020-April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. Results There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [-58%; 95% confidence interval (CI),-63% to-51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32-1.45] and intensive care unit (OR, 1.20; 95% CI, 1.01-1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45-1.56). Mental health-related visits in children declined in the early-pandemic period (in <10 years,-60%; 95% CI,-67% to-51%; in children ≥10 years:-56%; 95% CI,-63% to-47%) relative to the pre-COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change:-55%; 95% CI,-61% to-49%; P < 0.001). Conclusions After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs.

AB - Objectives The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. Methods This study is an interrupted-Time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018-January 27, 2020), peripandemic (January 28, 2020-March 10, 2020), and early pandemic (March 11, 2020-April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. Results There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [-58%; 95% confidence interval (CI),-63% to-51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32-1.45] and intensive care unit (OR, 1.20; 95% CI, 1.01-1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45-1.56). Mental health-related visits in children declined in the early-pandemic period (in <10 years,-60%; 95% CI,-67% to-51%; in children ≥10 years:-56%; 95% CI,-63% to-47%) relative to the pre-COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change:-55%; 95% CI,-61% to-49%; P < 0.001). Conclusions After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs.

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Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study

Resumen

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PubMed: MeSH publication types

ODS de las Naciones Unidas

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