Patterns of presentations of children to emergency departments across Europe and the impact of the COVID-19 pandemic: retrospective observational multinational study
Diğer yayınlar > Diğer · 2022
Yazarlar: Ruud G. Nijman, Kate Honeyford, Ruth Farrugia, Katy Rose, Zsolt Bognar, Danilo Buonsenso, Liviana Da Dalt, Tisham De, Ian K. Maconochie, Niccolo Parri, Damian Roland, Tobias Alfven, Camille Aupiais, Michael Barrett, Romain Basmaci, Dorine Borensztajn, Susana Castanhinha, Vasilico Corrine, Sheena Durnin, Paddy Fitzpatrick, Laszlo Fodor, Borja Gomez, Susanne Greber-Platzer, Romain Guedj, Stuart Hartshorn, Florian Hey, Lina Jankauskaite, Daniela Kohlfuerst, Mojca Kolnik, Mark D Lyttle, Patrícia Mação, Maria Inês Mascarenhas, Shrouk Messahel, Esra Akyüz Özkan, Zanda Pučuka, Sofia Reis, Alexis Rybak, Malin Ryd Rinder, Ozlem Teksam, Caner TURAN, Valtýr Stefánsson Thors, Roberto Velasco, Silvia Bressan, Henriette A Moll, Rianne Oostenbrink, Luigi Titomanlio
Diğer, Uluslararası, 2022,
Özet
Abstract Background To investigate the impact of the COVID-19 pandemic and infection prevention measures on children visiting emergency departments across Europe. Methods Routine health data were extracted retrospectively from electronic patient records of children aged <16 years, presenting to 38 emergency departments (ED) in 16 European countries for the period January 2018 – May 2020, using predefined and standardized data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRR) were used to compare age groups, diagnoses and outcomes. Findings Reductions in pediatric ED attendances, hospital admissions and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (incidence rate ratio (IRR) 2·62, 95% CI 2·19 to 3·13) and in children aged >12 months (12-<24 months IRR 0·89, 95% CI 0·86 to 0·92; 2-<5years IRR 0·84, 95% CI 0·82 to 0·87; 5-<12 years IRR 0·74, 95% CI 0·72 to 0·76; 12-<16 years IRR 0·74, 95% CI 0·71 to 0·77; vs. age <12 months as reference group). The impact on pediatric intensive care admissions (IRR 1·30, 95% CI 1·16 to 1·45) was not as great as the impact on general admissions. Lower triage urgencies were reduced more than higher triage urgencies (urgent triage IRR 1·10, 95% CI 1·08 to 1·12; emergent and very urgent triage IRR 1·53, 95% CI 1·49 to 1·57; vs. non-urgent triage category). Reductions were highest and sustained throughout the study period for children with communicable infectious diseases. Interpretation: Reductions in ED attendances were seen across Europe during the first COVID-19 lockdown period. More severely ill children continued to attend hospital more frequently compared to those with minor injuries and illnesses, although absolute numbers fell. Funding: RGN was supported by National Institute of Health Research, award number ACL-2018-021-007. Trial registry: ISRCTN91495258