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Volume 8
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10.3390/children8060463
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Brief Report

Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period

by
Giampiero Bottari
1,*,
Giandomenico Stellacci
2,
Davide Ferorelli
1,
Alessandro Dell’Erba
1,
Maurizio Aricò
3,
Marcello Benevento
1,
Giuseppe Palladino
2 and
Biagio Solarino
1
1
Department of Interdisciplinary Medicine (DIM), Institute of Legal Medicine, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
2
Department of Pediatric Radiology, Giovanni XXIII Pediatric Hospital, Via G. Amendola 207, 70126 Bari, Italy
3
COVID-19 Management Crisis Unit, Giovanni XXIII Pediatric Hospital, Via G. Amendola 207, 70126 Bari, Italy
*
Author to whom correspondence should be addressed.
Children 2021, 8(6), 463; https://doi.org/10.3390/children8060463
Submission received: 29 April 2021 / Revised: 28 May 2021 / Accepted: 30 May 2021 / Published: 1 June 2021
(This article belongs to the Special Issue Pediatric Health Policy)
Versions Notes

Abstract

During the COVID-19 pandemic, the number of accesses to the Pediatric Emergency Department (pED) in Italy sharply decreased by 30%. The purpose of this study is to evaluate how this novel setting impacted on management of children with trauma, and the use and appropriateness of imaging studies in such patients at the pED. All imaging studies performed in patients with trauma at the pED of a tertiary children’s Hospital during the first wave of the COVID-19 pandemic (between March and May 2020) were reviewed, in comparison with a control time interval (March to May 2019). In the pre-COVID control era, 669 imaging studies documented bone fractures in 145/568 children (25.5%). In the COVID-era, 79/177 (44.6%) pediatric patients showed bone fractures on 193 imaging studies. Comparative analysis shows a 71% decrease in imaging studies, and the proportion of negative imaging studies (with no evidence of bone fractures) dropped in 2020 by 19% compared to the 2019 control era (p < 0.001). The sharp decrease of negative studies suggests that the rate of appropriateness was higher during COVID-era, suggesting some attitude toward defensive medicine in the previous control year, as a result of some degree of imaging inappropriateness. The impact of a pandemic on emergency medicine may offer a unique opportunity to revisit diagnostic and therapeutic protocols in pediatrics.
Keywords: COVID-19; pediatric emergency department; pediatric radiology department; diagnostic imaging; imaging appropriateness; healthcare policy COVID-19; pediatric emergency department; pediatric radiology department; diagnostic imaging; imaging appropriateness; healthcare policy

Share and Cite

MDPI and ACS Style

Bottari, G.; Stellacci, G.; Ferorelli, D.; Dell’Erba, A.; Aricò, M.; Benevento, M.; Palladino, G.; Solarino, B. Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period. Children 2021, 8, 463. https://doi.org/10.3390/children8060463

AMA Style

Bottari G, Stellacci G, Ferorelli D, Dell’Erba A, Aricò M, Benevento M, Palladino G, Solarino B. Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period. Children. 2021; 8(6):463. https://doi.org/10.3390/children8060463

Chicago/Turabian Style

Bottari, Giampiero, Giandomenico Stellacci, Davide Ferorelli, Alessandro Dell’Erba, Maurizio Aricò, Marcello Benevento, Giuseppe Palladino, and Biagio Solarino. 2021. "Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period" Children 8, no. 6: 463. https://doi.org/10.3390/children8060463

APA Style

Bottari, G., Stellacci, G., Ferorelli, D., Dell’Erba, A., Aricò, M., Benevento, M., Palladino, G., & Solarino, B. (2021). Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period. Children, 8(6), 463. https://doi.org/10.3390/children8060463

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