Association between the 2022 FIFA world cup and pediatric emergency department attendance during a winter respiratory virus surge: a retrospective multicenter study

Abstract Background Escalating pediatric emergency department (PED) visits raise concerns about crowding and low-acuity attendance. We aimed to assess whether live broadcasts of the 2022 FIFA World Cup were associated with changes in PED attendance and left-without-being-seen (LWBS) rates. Methods This retrospective, multicenter study recorded visit rates (primary outcome) from October 1 to December 31 in both 2021 and 2022, covering the FIFA World Cup period, and included patients who left without being seen (LWBS; secondary outcome) in two tertiary PEDs. Differences in outcomes between game and nongame periods in 2021 and 2022 were analyzed via permutation tests, which were stratified by the Canadian Triage Acuity Scale (CTAS). A subgroup analysis focused on games with at least 300,000 television or online media viewers. Results There were 16,889 visits in 2021 and 19,566 in 2022. The standardized visit rate (i.e., the share of a day’s total visits occurring during match windows) decreased or remained stable across acuity levels, with a significant decrease for CTAS 2–3 patients from 12.5% of daily visits in 2021 to 11.2% in 2022 ( p = 0.002). During game time, the proportion of LWBS patients among CTAS 4–5 visits decreased significantly (10.1% vs. 15.2%, p = 0.018). These effects were stronger when only high-audience games were considered. Conclusions Despite an overall increase in PED attendance in 2022, World Cup match periods were associated with a lower standardized proportion of CTAS 2–3 visits and a reduced LWBS rate among CTAS 4–5 patients. These findings suggest a temporary change in the timing and distribution of pediatric emergency care use rather than a clear reduction in overall or low-acuity attendance. Study registration ClinicalTrials.gov NCT05818215, retrospectively registered on April 18, 2023.