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코로나바이러스감염증-19 범유행과 연관된 응급실 방문의 변화

Coronavirus disease 2019 pandemic-related change in children’s visits to the emergency department

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참고문헌

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주제분류소아과학

초록

Purpose: This study was performed to investigate the coronavirus disease 2019 pandemic-related changes in visiting pattern of an emergency department (ED). Methods: The author investigated all children younger than 19 years who visited the ED from 2018 through 2020 without exclusion criteria. Pandemic period was defined as 2020. Variables of interest were monthly and annual numbers of visits, age and age groups (< 1, 1-4, 5-9, 10-14, and 15-18 years), sex, visits for diseases, disposition, high acuity, and top 5 chief complaints per each age group. Timing of social distancing and influenza-related visits were additionally analyzed to speculate the impact of such variables on the visiting patterns. Results: The annual visits were 11,435 (2018), 10,741 (2019), and 5,626 (2020), with a 47.6%-50.8% pandemic-related decrease. Trauma-related visits increased from 27.7%-28.4% to 36.5% (P < 0.001). In the children aged 9 years or younger, trauma as a chief complaint increased from 22.2%-29.6% to 36.2%-42.5% while fever decreased from 27.7%-47.3% to 16.7%-42.6%. In the pre-pandemic period, visits increased in February-March and October-December with a sharp increase in influenza-related visits in the latter 3 months. During the pandemic, a sharp decline in the visits was noted in January- February without the above-mentioned increasing patterns in neither total nor influenza-related visits. After the social distancing was implemented in the 13th week of 2020, the visits remained steady until a slight increase was noted after the school opening. Conclusion: During the pandemic period, a decrease was noted in the numbers of visits to the ED, along with decreases in fever as a chief complaint in young children and influenza-related visits, and the mitigation of social distancing. These findings could be useful in preparing emergency medicine resources for ongoing and future pandemics.

Abstract

Purpose: This study was performed to investigate the coronavirus disease 2019 pandemic-related changes in visiting pattern of an emergency department (ED). Methods: The author investigated all children younger than 19 years who visited the ED from 2018 through 2020 without exclusion criteria. Pandemic period was defined as 2020. Variables of interest were monthly and annual numbers of visits, age and age groups (< 1, 1-4, 5-9, 10-14, and 15-18 years), sex, visits for diseases, disposition, high acuity, and top 5 chief complaints per each age group. Timing of social distancing and influenza-related visits were additionally analyzed to speculate the impact of such variables on the visiting patterns. Results: The annual visits were 11,435 (2018), 10,741 (2019), and 5,626 (2020), with a 47.6%-50.8% pandemic-related decrease. Trauma-related visits increased from 27.7%-28.4% to 36.5% (P < 0.001). In the children aged 9 years or younger, trauma as a chief complaint increased from 22.2%-29.6% to 36.2%-42.5% while fever decreased from 27.7%-47.3% to 16.7%-42.6%. In the pre-pandemic period, visits increased in February-March and October-December with a sharp increase in influenza-related visits in the latter 3 months. During the pandemic, a sharp decline in the visits was noted in January- February without the above-mentioned increasing patterns in neither total nor influenza-related visits. After the social distancing was implemented in the 13th week of 2020, the visits remained steady until a slight increase was noted after the school opening. Conclusion: During the pandemic period, a decrease was noted in the numbers of visits to the ED, along with decreases in fever as a chief complaint in young children and influenza-related visits, and the mitigation of social distancing. These findings could be useful in preparing emergency medicine resources for ongoing and future pandemics.

참고문헌 (11)

  1. Choi Dong Hyun, "Impact of the COVID-19 Outbreak on Trends in Emergency Department Utilization in Children: a Multicenter Retrospective Observational Study in Seoul Metropolitan Area, Korea", Journal of Korean Medical Science, 36(5), pp.1~11 (2021), 대한의학회[DOI]
  2. 황승연, "코로나바이러스감염증-19 범유행이 한국 대도시 응급실 이용에 미치는 장기 영향", 대한소아응급의학회지, 8(2), pp.57~65 (2021), 대한소아응급의학회
  3. 김진아, "Effect of coronavirus disease 2019 on febrile children’s visits to the emergency department of a tertiary hospital", 대한소아응급의학회지, 8(1), pp.8~15 (2021), 대한소아응급의학회
  4. 김홍민, "Effect of coronavirus disease 2019 pandemic on children’s visits to the emergency department", 대한소아응급의학회지, 9(1), pp.10~16 (2022), 대한소아응급의학회
  5. Pines JM, "Characterizing pediatric emergency department visits during the COVID-19 pandemic", Am J Emerg Med, 41, pp.201~204 (2021)
  6. Scheier E, "The injury-illness dichotomy of COVID-19 on the pediatric ED", Am J Emerg Med, 52, pp.244~248 (2022)
  7. Isba R, "COVID-19 : transatlantic declines in pediatric emergency admissions", Pediatr Emerg Care, 36, pp.551~553 (2020)
  8. Dopfer C, "COVID-19 related reduction in pediatric emergency healthcare utilization-a concerning trend", BMC Pediatr, 20, pp.427~ (2020)
  9. 정진희, "한국 소아전문응급의료센터 역할 강화", 대한소아응급의학회지, 4(2), pp.29~33 (2017), 대한소아응급의학회[DOI]
  10. Fraymovich S, "A blueprint for pediatric emergency resource reallocation during the COVID-19 pandemic : an NYC hospital experience", Pediatr Emerg Care, 36, pp.452~454 (2020)
  11. Tommaso Bellini, "A potential impact of the donning and doffing policy on emergency department length of stay during the coronavirus disease 2019 pandemic", 대한소아응급의학회지, 8(2), pp.124~126 (2021), 대한소아응급의학회

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