Characterization of Pediatric Imaging Trends and Likelihood of Exam Cancellation in the COVID-19 Pandemic

• Main Authors: Briggs, D. (Author), Gallo-Bernal, S. (Author), Gee, M.S (Author), Machado-Rivas, F. (Author), Pianykh, O. (Author)
• Format: Article
• Language: English
• Published: Elsevier Inc. 2022
• Subjects: adolescent; Adolescent; age; anesthesia; Anesthesia; Article; Cancellation; child; Child; Child, Preschool; Children; clinical study; computer assisted tomography; congenital disorder; controlled study; coronavirus disease 2019; COVID-19; demographics; developmental disorder; electronic health record; epidemiology; examination; female; fluoroscopy; human; Humans; Imaging; infant; Infant; Infant, Newborn; major clinical study; male; Male; multivariate logistic regression analysis; newborn; nuclear magnetic resonance imaging; oncological procedure; Orders; pain; pandemic; Pandemics; Pediatric radiology; pediatrics; preschool child; radiology; Radiology; Retrospective Studies; retrospective study; SARS-CoV-2; sex difference; trend study; ultrasound
• Online Access: View Fulltext in Publisher

 Rationale and Objective: The COVID-19 pandemic has caused unprecedented changes in radiology practice worldwide. There is a need for a framework of pediatric radiology resource allocation for future acute resource-limited settings.The aim of this study is to quantify and analyze changes in pediatric radiology practice during the COVID-19 pandemic considering demographic and clinical characteristics. Materials and Methods: We retrospectively searched our institution's electronic health record for pediatric imaging exams from 09/15/19 to 05/01/20, with 03/15/20 as the dividing date between baseline and pandemic periods. Age, modality, exam indication, need for anesthesia/sedation, and exam completion or cancellation were recorded. All exams were compared between baseline and pandemic periods using a chi-square test and a logistic regression multivariate analysis. Results: 15,424 exams were included for analysis [13,715 baseline period (mean age 10±5 years; 7440 males); 1047 COVID-19 period (mean age 9±5 years; 565 males)]. A statistically significantly lower proportion of adolescent exams (45.5% vs 53.3%), radiography modality (62.4% vs 70.4%) and non-traumatic pain indication (39.1% vs 46.3%) was observed during the COVID-19 period. Conversely, we found a higher proportion of neonatal (5.8% vs 3.8%), infant (5.6% vs 4.1%) and early childhood patients (12.9% vs 9.8%), CT (7.4% vs 5.9%) and ultrasound modalities (18.3% vs 13.5%), oncologic (8.8% vs 6.5%) and congenital/development disorder indications (6% vs 3.9%), and studies performed under anesthesia (2.7% vs 1.3%). Regarding exam completion rates, the neonatal age group (OR 1.960 [95% CI 0.353 – 0.591]; p <0.020) and MRI modality (OR 1.502 [95% CI: 0.214 – 0.318]; p <0.049) had higher odds of completion during the COVID-19 pandemic, while fluoroscopy modality was associated with lower odds of completion (OR 0.524 [95% CI: 0.328 – 0.839]; p = 0.011). Conclusion: The composition and completion of pediatric radiology exams changed substantially during the COVID-19 pandemic. A sub-set of exams resilient to cancellation was identified. © 2021 The Association of University Radiologists