Impact of “Stay-at-Home” orders on non-accidental trauma: A multi-institutional study

Midwest Pediatric Surgery Consortium

Research output: Contribution to journalArticlepeer-review


Background: It is unclear how Stay-at-Home Orders (SHO) of the COVID-19 pandemic impacted the welfare of children and rates of non-accidental trauma (NAT). We hypothesized that NAT would initially decrease during the SHO as children did not have access to mandatory reporters, and then increase as physicians’ offices and schools reopened. Methods: A multicenter study evaluating patients <18 years with ICD-10 Diagnosis and/or External Cause of Injury codes meeting criteria for NAT. “Historical” controls from an averaged period of March-September 2016–2019 were compared to patients injured March-September 2020, after the implementation of SHO (“COVID” cohort). An interrupted time series analysis was utilized to evaluate the effects of SHO implementation. Results: Nine Level I pediatric trauma centers contributed 2064 patients meeting NAT criteria. During initial SHO, NAT rates dropped below what was expected based on historical trends; however, thereafter the rate increased above the expected. The COVID cohort experienced a significant increase in the proportion of NAT patients age ≥5 years, minority children, and least resourced as determined by social vulnerability index (SVI). Conclusions: The COVID-19 pandemic affected the presentation of children with NAT to the hospital. In times of public health crisis, maintaining systems of protection for children remain essential.

Original languageEnglish
Pages (from-to)1062-1066
Number of pages5
JournalJournal of Pediatric Surgery
Issue number6
StatePublished - Jun 2022


  • Child abuse
  • COVID-19
  • Non-accidental trauma
  • Pediatric trauma


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