COVID-19 Lockdown Has No Significant Impact on Trauma Epidemiology and Outcomes in a Tertiary Trauma Center—Retrospective Cohort Study (original) (raw)
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Wiener klinische Wochenschrift, 2021
Summary Objective The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and its associated illness, coronavirus disease 2019 (COVID-19), has led to a global health crisis burdening frontline emergency departments, including orthopedic and trauma units. The aim of this study was to provide an overview of the impact of the lockdown secondary to the pandemic on patient numbers and pattern of injuries at the department of traumatology of the Medical University of Vienna. Methods This retrospective, descriptive study identified all patients admitted and enrolled onto the trauma registry at a level I trauma center, between 15 March 2020 and 30 April 2020 (lockdown) and compared them to those between 15 March 2019 and 30 April 2019 (baseline). Variables collected included patient age, sex, reason for hospital admission, place of injury, death, injury severity score (ISS), as well as American Society of Anaesthesiologists (ASA) score. Results A total of 10,938 patient...
Trauma workload during COVID19 lockdown: an analysis of incidence in 4 million people
Irish Journal of Medical Science (1971 -)
Background Aim of this study is to report the trauma workload during COVID19 lockdown in a region of four million people and to compare it with the same period in 2019. Methods The regional register for A&E admissions and hospitalizations has been reviewed in order to compare the number of A&D admission, the triage colour codes rates, aetiology of trauma, number of patients hospitalized for trauma, number of fractures that required surgery, type of fractures and injuries and mean patients' age. Results During lockdown 7314 patients were admitted in A&E, while 22,508 patients were admitted in 2019. In 2020 and 2019 triage codes were respectively distributed as follows: red code 0.1% vs 0.2%, yellow code 8.9% vs 6.3%, green code 84% vs 84.7% and white code 6% vs 8.8%. (p = 0.042). The number of hospitalized patients for trauma was 670 in 2020, while in 2019 was 1774 (p = 0.02). The most common fracture that required surgery was femur fracture (409 in 2020 vs 635 in 2019); fracture subtype distribution and mean age of the patients were significantly different in the two groups (respectively p < 0.01 and p = 0.02). Conclusions One month of lockdown showed a 68% decrease in the number of A&E visits and a 74% decrease of fractures that required surgery. Femur fracture showed the lowest decrease moving from 635 to 409 units but increasing their incidence rate (42 to 61%).
International journal of Community Medicine and Public Health , 2023
Background: Injuries show a significant burden of morbidity, disability and mortality throughout world, especially in lower-middle income nations. Injuries result from road traffic crashes, falls, burns, and acts of violence against oneself or others, among other causes. Road Traffic Accidents are especially dominant among injuries, which are unintentional. The lockdown has resulted in dramatic changes in service provision from emergency departments and hospitals. And the pattern of the injuries has differed because of different reasons being reduced mobility, isolation at home, boredom and so on. The aim of this study was to assess the type of injury cases reaching a tertiary care hospital in Bangalore before, during and after lockdown of the COVID-19 pandemic and its profile. Methods: The data was collected from the hospital records of all inpatients of selected tertiary care hospitals. Results: Incidence of RTA and Assaults are observed to be high constituting 52.5% and 31.4% respectively. The change in trend of injuries indicated a dropdown in injury cases during lockdown and the increase of cases after lockdown relaxations. Conclusions: Road traffic accidents was the most common cause of injury observed in this study, with specifically 2wheeled vehicles were most involved. The development of trauma registries all over the country containing minimum epidemiologically desired data is the need of the time for India. The data in the hospital records should be standardized and centralized.
The effect of nationwide lockdown on the epidemiology of injuries during the first wave of COVID-19
Travmatologiâ i Ortopediâ Rossii, 2023
Background. The pattern of hospital admissions and medical care changed during the COVID pandemic. The aim of the study-to describe the nature of patients attending the orthopedic emergency department of a level 1 trauma center in terms of number and proportion based on demographic characteristics and the nature of the injury before the lockdown, during the lockdown, and during the unlocking period of the nationwide lockdown for controlling the COVID-19 pandemic in India. Methods. We conducted a longitudinal study from 01.01.2020 to 31.12.2020. Patients attending the orthopedic emergency were grouped based on cause, type, and site of injury. The median number observed each day with IQR. The distribution of the same was compared between the prelockdown with lockdown period and the lockdown period with a phased unlocking period. Results. A total of 10513 patients were included. There was a statistically significant reduction in the proportion of patients needing inpatient care between the prelockdown phase and lockdown phase (p = 0.008). However, this was not seen between lockdown and postlockdown periods (p = 0.47). The proportion of road traffic accidents dropped from 26% to 15% during this time (p<0.001). The proportion of contusions was reduced and that of soft tissue injuries increased (p<0.001). The proportion of lower limb injuries decreased from the prelockdown phase to the lockdown phase, and that of spinal injury patients increased (p = 0.007). The proportion of patients with contusions increased and soft tissue injuries decreased during this period (p<0.001). Lower limb injuries and road traffic accidents increased, and spinal injuries were reduced (p<0.001). Conclusion. The lockdown for controlling the spread of the pandemic affected the demographic and epidemiological aspects of injuries attending the orthopedic emergency department of a level 1 trauma center in a developing country. There was a decrease in the proportion of females and children attending the ED during the lockdown. The number of road traffic accedents s decreased during the lockdown. The number of patients with contusions attending the trauma center during the lockdown decreased, but there was an increase in the number of patients with spine injuries. We suggest that improvement in triage facilities, wider use of telemedicine, and increasing the stock of PPEs are essential for tackling such situations in the future.
The Impact Of The COVID-19 Lockdown On The Severity Of Pediatric Traumas
Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi
We aimed to evaluate the results of COVID-19 lockdown in terms of child traumas and to reveal the change in the characteristics and severity of traumas by comparing the lockdown period with the same period one year ago. Material and Method: The records of pediatric trauma patients were assessed retrospectively. The data of all pediatric traumas between the specified dates were reached and the sample of the study was determined as 1970 patients. Descriptive characteristics of patients and trauma events were determined. Patient data were reassessed , and Pediatric Trauma Scores, and Pediatric Glasgow Coma Scale values, and Injury Severity Scores were calculated. Results: Of the patients, 1637 (83.1%) had admitted before the lockdown and 333 admitted during the lockdown period. It was found that the school-age children constituted the group with the most prevalent trauma patients in both periods with a rate of 76.2% before the lockdown and 49.8% in the lockdown period. It was found that the measure of lockdown reduced the rate of outdoor trauma cases from 63.2% to 43.2% (p<0.001). Whereas a statistically significant decrease was determined in the mean scores of the Pediatric Trauma Score and the Pediatric Glasgow Coma Scale, no difference was determined in the Injury Severity Score. Conclusion: It is seen that the COVID-19 pandemic and its restrictions, which change our normal life in every aspect, also have effects on pediatric traumas. It is noticed atthis study that not only the number of traumas but also the severe traumas and mortality decreased during the lockdown.
European Journal of Trauma and Emergency Surgery, 2020
Purpose The COVID-19 pandemic has impacted healthcare systems globally, little is known about the trauma patterns during a national lockdown. The aim of this study is to delineate the trauma patterns and outcomes at Aintree University Teaching Hospital level 1 Major Trauma Centre (MTC) during the COVID-19 lockdown imposed by the U.K. government. Methods A retrospective cohort study data from the Merseyside and Cheshire Trauma Audit and Research Network database were analysed. The 7-week 'lockdown period' was compared to a 7-week period prior to the lockdown and also to an equivalent 7-week period corresponding to the previous year. Results A total of 488 patients were included in the study. Overall, there was 37.6% and 30.0% reduction in the number of traumatic injuries during lockdown. Road traffic collisions (RTC) reduced by 42.6% and 46.6%. RTC involving a car significantly reduced during lockdown, conversely, bike-related RTC significantly increased. No significant changes were noted in deliberate self-harm, trauma severity and crude mortality during lockdown. There was 1 mortality from COVID-19 infection in the lockdown cohort. Conclusion Trauma continues during lockdown, our MTC has continued to provide a full service during lockdown. However, trauma patterns have changed and departments should adapt to balance these alongside the COVID-19 pandemic. As the U.K. starts its cautious transition out of lockdown, trauma services are required to be flexible during changes in national social restrictions and changing trauma patterns. COVID-19 and lockdown state were found to have no significant impact on survival outcomes for trauma.
THE EFFECTS OF NATIONAL LOCKDOWN ON TRAUMA ADMISSIONS AND SURGICAL CASES AT OUR TERTIARY CARE CENTER
The aim of this study is to gain a greater understanding of the impact lockdown has had on the rates, mechanisms and types of injuries together with their management across a regional trauma service. Materials & Methods: Data was collected from our trauma centre of Swaroop Rani Nehru Hospital, Prayagraj. Data collection included patient demographics, injury mechanism, injury type and treatment required. Time periods studied corresponded with the 41 days leading up to lockdown rd in India and the 41 days during the lockdown (25 march to 3 May, 2020). Results: There was a 72% (612 vs 171) reduction in total accident and emergency (A&E) admissions during lockdown compared to pre-lockdown period. The number of patients with fragility fractures requiring admission almost remained similar (12 patients pre-lockdown vs 08 patients during lockdown; p > 0.05). Fall from Height were the commonest cause of major trauma admissions during lockdown. There was a signicant reductions in RTA cases during lockdown (248 vs 20) which can be deduced to be most fruit-full outcome from the lockdown, as far as trauma cases are concerned. Conclusion: The national lockdown is designed to limit the spread of COVID-19. Due to the guidance measures in place it has had a secondary impact of reducing trauma requiring admission in our region by 72%. The mostly affected mode of injury due to lockdown remains to be the RTAs and the most common mode of injury leading to major trauma during lockdown proves to be fall from height.
Injury Mechanism, Volume, and Severity of General Surgical Trauma Patients During COVID-19 Lockdown
Cureus, 2021
Background After the declaration of the COVID-19 pandemic, countries have taken many restriction measures to reduce the spread of the virus and ensure the health system's proper functioning. Our knowledge about the general surgery trauma patients being affected by the restrictions is very limited. Objective To examine the association of the lockdown measurements during the COVID-19 pandemic with general surgical trauma patients' volume and severity at a university teaching hospital. Methods All patients admitted to the emergency department because of trauma and evaluated by the general surgery team were examined in two groups. The COVID-19 restrictions period (17 March 2020-31 May 2020) and the corresponding time last year (17 March 2019-31 May 2019). Demographic properties, injury mechanisms, emergency trauma scores (ETS), hospital length of stays (HLOS), intensive care unit (ICU) admission rates, surgical interventions, and mortality were compared. Results The number of patients in the restrictions period is 30% lower than the before COVID-19 cohort. ETS was significantly higher in the restrictions period compared to the previous year, whereas no significant difference was detected in terms of injury mechanisms between the groups (p=0.001 vs p=0.493, respectively). HLOS was found to be higher in the restrictions period (p=0.038). Conclusions Although there was a decrease in the number of general surgical trauma admissions, a significant increase in the severity of trauma was observed during COVID-19 restrictions. We hope these findings will help authorities to guide resource allocation in future pandemic waves.
The New Zealand medical journal, 2020
AIM The aims of this study were to describe the variation in volumes and types of injuries admitted to a level one trauma centre in New Zealand over two 14-day periods before and during the national level 4 lockdown for COVID-19; and highlight communities at risk of preventable injury that may impact negatively on hospital resources. METHOD A retrospective, descriptive study of prospectively collected data in the Midland Trauma Registry in New Zealand. RESULTS Overall there was a reduction of 43% in all injury-related admissions with significant reductions seen in major injury (50% reduction), males (50% reduction) and children aged 0-14 years (48% reduction). Results for ethnicity and persons aged over 14 years were within 3% deviation of this overall 43% reduction. Injuries at home, particularly falls, predominate. CONCLUSION Despite the significant reduction in admissions during level 4 lockdown, hospitals should continue to provide full services until resource limitations are un...