P54. Emergency department visits for pediatric spine fractures: trends through COVID-19

BACKGROUND CONTEXT: Pediatric spine fractures are an important medical and surgical emergency. PURPOSE: The aim of this study was to assess trends in emergency department visits for pediatric spine fractures. STUDY DESIGN/SETTING: Descriptive Epidemiological Study. PATIENT SAMPLE: A total of 1,930 (national estimate: 49,186) pediatric patients who presented to the emergency room with a spine fracture from 2001 to 2020. OUTCOME MEASURES: Causes of spine fractures, discharge disposition and demographic variables. METHODS: The National Electronic Injury Surveillance System (NEISS) database is a probability sample of hospitals in the United States. This sample was stratified and weighted based on ED size, which was used to generate national estimates (NE). The NEISS database from 2001 to 2020 was queried for less than 18 years old who sustained a cervical, thoracic or lumbar spine fracture. The entire cohort was divided by before and after March 11, 2020, which is when the WHO declared the COVID-19 pandemic. RESULTS: There were 1,930 (NE: 49,186) pediatric patients who presented to the emergency room with a spine fracture from 2001 to 2020. There were 135 (NE:2,807) ED patients in 2020 compared to 110 (NE: 2,161) in 2019 representing a 30% increase compared to the year before. The rate of males with spine fractures decreased (50.88% DC vs. 62.77% BC; p < 0.001). The rate of spine fractures at home increased (30% DC vs. 22% BC; p < 0.001) while rate of spine fractures in a place of recreation decreased (25% DC vs. 34% BC; p < 0.001). Lumbar spine fractures decreased (15% vs. 24%) while cervical and thoracic spine fractures increased (p < 0.001). The amount of ED spine fractures leading to admission decreased (14.69% DC vs 25% BC) while the amount released increased (61% vs. 55%) (p < 0.001). The most decreased three causes of pediatric spine fractures were football (6.84% DC vs. 11.18% BC), stairs (1.72% DC vs. 5.89% BC), and sleds (0.22% DC vs. 4.34% BC) (p < 0.001). The most increased three causes of pediatric spine fractures in the ED were swings (8.57% DC vs. 1.31% BC), horseback riding (10.85% DC vs. 4.35% BC), and ATV vehicles (7.92% DC vs. 1.91% BC) (all p < 0.001). CONCLUSIONS: There was a spike in pediatric spine fractures during the COVID-19 pandemic compared to the year before. Fractures in males, and those related to recreational activities in public places as well as fractures due to football decreased. Fractures at home and in isolated recreational activities such as swings, horseback riding and ATVs increased. FDA DEVICE/DRUG STATUS: This abstract does not discuss or include any applicable devices or drugs.