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1.
BMC Emerg Med ; 22(1): 167, 2022 10 06.
Article in English | MEDLINE | ID: covidwho-2053863

ABSTRACT

BACKGROUND: Understanding the changes in characteristics of patients who visited trauma centres during the coronavirus disease 2019 (COVID-19) pandemic is important to facilitate aneffective response. This retrospective study was conducted to analyse differences in the characteristics and outcomes of patients who visited our trauma centre between pre-COVID-19 and COVID-19 eras. METHODS: Medical data of trauma patients enrolled in the Korean trauma database from 1 January 2018 to 31 August 2021 were collected. The number of trauma centre visits, patient characteristics, factors associated with in-hospital intervention, and outcomes werecompared between patients in the two time periods. Propensity score matching was performed to analyse the outcomes in patients with similar characteristics and severitybetween patients in the two time periods. RESULTS: The number of emergency department (ED) trauma service visits reduced in the COVID-19 era. Based on the mean age, the patients were older in the COVID-19 era. Abbreviated injury scale (AIS) 1, AIS3, AIS5, and injury severity score (ISS) were higher in the COVID-19 era. The proportion of motor vehicle collisions decreased, whereas falls increased during the COVID-19 era. Ambulance transportation, admission to the general ward, and time from injury to ED visit significantly increased. Patient outcomes, such as hospital length of stay (LOS), intensive care unit (ICU) LOS, and duration of mechanical ventilation improved, while injury severity worsened during the COVID-19 era. After adjusting for patient characteristics and severity, similar findings were observed. CONCLUSION: The small reduction in the number of trauma patients and visits by patients who hadhigher ISS during the COVID-19 pandemic highlights the importance of maintaining trauma service capacity and capability during the pandemic. A nationwide or nationalmulticentre study will be more meaningful to examine the impact of the COVID-19 outbreak on the changes in trauma patterns, volume, and patient outcomes.


Subject(s)
COVID-19 , Wounds and Injuries , COVID-19/epidemiology , Humans , Injury Severity Score , Length of Stay , Pandemics , Retrospective Studies , Trauma Centers , Wounds and Injuries/epidemiology , Wounds and Injuries/therapy
2.
Injury ; 53(8): 2790-2794, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1983245

ABSTRACT

PURPOSE: Injury prevention is important. Injury as a result of an accident carries with it huge cost to the individual and society including health services costs. Understanding the mechanism of injury is important to identify those injuries that are preventable. The aim of this study was to assess how many acute orthopaedic injuries were preventable should reasonable human interventions have been taken METHODS: This prospective study was performed in a UK district general hospital that serves a population of 500,000 people. All patients referred to the Orthopaedic department over 4 weeks between 16th November and 14th December 2020 were reviewed. Data was collected about the mechanism of injury, patient demographics, injury type, injury location, treatment and length of stay in hospital. The mechanisms of injury were analysed thematically. RESULTS: We assessed 605 patient attendances. 502 patients sustained 516 acute traumatic injuries. Preventable injuries were common, accounting for 23.9% of all referrals. The upper limb was most commonly injured with the hand and forearm being injured 33% of the time. Of the preventable injuries 35% were treated operatively. Thematic analysis identified common mechanisms of: occupational related, stairs, RTA, cycling, alcohol related, trampoline, DIY and assault. CONCLUSION: This study identifies that a large proportion of acute orthopaedic injuries are potentially preventable meaning this is an important area for further study. Occupation injuries were identified as an area in which there is the greatest scope to reduce the number of preventable accidents.


Subject(s)
Orthopedics , Wounds and Injuries , Humans , Prospective Studies , Retrospective Studies , Upper Extremity/injuries , Wounds and Injuries/epidemiology , Wounds and Injuries/prevention & control
3.
Eur J Trauma Emerg Surg ; 48(4): 3011-3016, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1982102

ABSTRACT

AIM: We aimed to study the impact of the COVID-19 pandemic on the pattern of injury and outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates, to use this information in the preparedness for future pandemics. METHODS: We retrospectively compared the trauma registry data of all hospitalised trauma patients, who were treated at the two main trauma centres in Al-Ain City (Al-Ain Hospital and Tawam Hospital); those who were treated over 1 year before the pandemic (n = 2002) and those who were treated at the first year of the COVID-19 pandemic (n = 1468). RESULTS: There was a 26.7% reduction in the overall incidence of trauma admissions in the COVID-19 pandemic period. The mechanism of injury significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase in the number of injuries, due to machinery and falling objects during the pandemic (39.7% and 54.1% respectively, p < 0.001). In contrast, road traffic collisions and falls were reduced by 33.5% and 31.3%, respectively. Location significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase of 18.4% in workplace injuries and a reduction of 39.3% in home injuries over the study period. In addition, we observed relatively more workplace injuries and fewer home injuries during the pandemic (11.3% and 42.8% compared with 7.1% and 52.4%, respectively). Mortality was similar between the two periods (1.8% compared with 1.2%, p = 0.16, Fisher's exact test). CONCLUSIONS: The COVID-19 pandemic has modified the trauma risk exposure in our population. It reduced trauma hospital admissions by around 27%. Work-related injuries, including falling objects and machinery injuries, were relatively higher during the pandemic. Prevention of work-related injuries should be an important component of preparedness for future pandemics.


Subject(s)
COVID-19 , Occupational Injuries , Wounds and Injuries , COVID-19/epidemiology , Humans , Incidence , Occupational Injuries/epidemiology , Pandemics , Retrospective Studies , United Arab Emirates/epidemiology , Wounds and Injuries/epidemiology , Wounds and Injuries/therapy
4.
Am Surg ; 88(8): 1916-1918, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1932937

ABSTRACT

INTRODUCTION: This study aims to improve public health outreach in a high-risk population. METHODS: This is a single center study of Trauma Registry data, inclusive years January 1, 2016 to March 30, 2021. The study population was stratified into two groups: ETOH ≥ 80 mg/dL and ETOH <80 mg/dL. A total of 1141 were included. RESULTS: Those above the legal drinking limit had a significantly higher mean ETOH (231 mg/dL; P <.01) and were typically younger men that arrived by ground ambulance. The significant injury patterns of those above the legal limit included full activation and consults who fell from stairs and fell from other or unknown. A higher proportion of intoxicated fall trauma patients above the legal limit were diagnosed with a concussion. CONCLUSIONS: Excess alcohol consumption, particularly during a pandemic year, may lead to a higher incidence of fall from stairs trauma in men who are more likely to be diagnosed with a concussion.


Subject(s)
Blood Alcohol Content , Wounds and Injuries , Alcohol Drinking/adverse effects , Alcohol Drinking/epidemiology , Humans , Incidence , Male , Registries , Risk Factors , Wounds and Injuries/diagnosis , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology
5.
PLoS One ; 17(5): e0268190, 2022.
Article in English | MEDLINE | ID: covidwho-1910636

ABSTRACT

This study investigates the important role of attendant factors, such as road traffic victims' access to trauma centres, the robustness of health infrastructure, and the responsiveness of police and emergency services in the incidence of Road Traffic Injuries (RTI) during the pandemic-induced COVID-19 lockdowns. The differential effects of the first and second waves of the pandemic concerning perceived health risk and legal restrictions provide us with a natural experiment that helps us differentiate between the impact of attendant factors and the standard relationship between mobility and Road Traffic Injuries. The authors use the auto-regressive recurrent neural network method on two population levels-Tamil Nadu (TN), a predominantly rural state, and Chennai, the most significant metropolitan city of the state, to draw causal inference through counterfactual predictions on daily counts of road traffic deaths and Road Traffic Injuries. During the first wave of the pandemic, which was less severe than the second wave, the traffic flow was correlated to Road Traffic Death/Road Traffic Injury. In the second wave's partial and post lockdown phases, an unprecedented fall of over 70% in Road Traffic Injury-Grievous as against Road Traffic Injury-Minor was recorded. Attendant factors, such as the ability of the victim to approach relief centres, the capability of health and other allied infrastructures, transportation and medical treatment of road traffic crash victims, and minimal access to other emergency services, including police, assumed greater significance than overall traffic flow in the incidence of Road Traffic Injury in the more severe second wave. These findings highlight the significant role these attendant factors play in producing the discrepancy between the actual road traffic incident rate and the officially registered rate. Thus, our study enables practitioners to observe the mobility-adjusted actual incidence rate devoid of factors related to reporting and registration of accidents.


Subject(s)
COVID-19 , Wounds and Injuries , Accidents, Traffic , COVID-19/epidemiology , Communicable Disease Control , Humans , India , Pandemics , Wounds and Injuries/epidemiology
6.
J Surg Res ; 279: 187-192, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1867433

ABSTRACT

INTRODUCTION: In attempts to quell the spread of COVID-19, shelter-in-place orders were employed in most states. Increased time at home, in combination with parents potentially balancing childcare and work-from-home duties, may have had unintended consequences on pediatric falls from windows. We aimed to investigate rates of falls from windows among children during the first 6 mo of the COVID-19 pandemic. METHODS: Patients <18 y old admitted to three pediatric trauma centers (two - level 1, one - level 2) between 3/19/20 and 9/19/20 (COVID-era) were compared to a pre-COVID cohort (3/19/19 to 9/19/19). The primary outcome was the rate of falls from windows. Secondary outcomes included injury severity score (ISS), injuries sustained, and mortality. RESULTS: Of 1011 total COVID-era pediatric trauma patients, 36 (3.6%) sustained falls from windows compared to 23 of 1108 (2.1%) pre-COVID era patients (OR 1.7, P = 0.05). The median ISS was seven pre-COVID versus four COVID-era (P = 0.43). The most common injuries sustained were skull fractures (30.5%), extremity injuries (30.5%), and intracranial hemorrhage (23.7%). One-fifth of patients underwent surgery (21.7% pre-COVID versus 19.4% COVID-era, P = 1.0). There was one mortality in the COVID-era cohort and none in the pre-COVID cohort (P = 1.0). CONCLUSIONS: Despite overall fewer trauma admissions during the first 6 mo of the COVID-19 pandemic, the rate of falls from windows nearly doubled compared to the prior year, with substantial associated morbidity. These findings suggest a potential unintended consequence of shelter-in-place orders and support increased education on home safety and increased support for parents potentially juggling multiple responsibilities in the home.


Subject(s)
COVID-19 , Wounds and Injuries , COVID-19/epidemiology , Child , Humans , Injury Severity Score , Pandemics , Retrospective Studies , Trauma Centers , Wounds and Injuries/epidemiology , Wounds and Injuries/therapy
7.
Inj Prev ; 28(3): 269-279, 2022 06.
Article in English | MEDLINE | ID: covidwho-1861642

ABSTRACT

BACKGROUND: Cohort studies play essential roles in assessing causality, appropriate interventions. The study, Post-crash Prospective Epidemiological Research Studies in IrAN Traffic Safety and Health Cohort, aims to investigate the common health consequences of road traffic injuries (RTIs) postcrash through multiple follow-ups. METHODS: This protocol study was designed to analyse human, vehicle and environmental factors as exposures relating to postcrash outcomes (injury, disability, death, property damage, quality of life, etc). Population sources include registered injured people and followed up healthy people in precrash cohort experienced RTIs. It includes four first-year follow-ups, 1 month (phone-based), 3 months (in-person, video/phone call), 6 and 12 months (phone-based) after crash. Then, 24-month and 36-month follow-ups will be conducted triennially. Various questionnaires such as Post-traumatic Stress Disorder Questionnaire, Patient Health Questionnaire, WHO Disability Assessment Schedules, Cost-related Information, etc are completed. Counselling with a psychiatrist and a medical visit by a practitioner are provided accompanied by extra tools (simulator-based driving assessment, and psychophysiological tests). Through preliminary recruitment plan, 5807, 2905, 2247 and 1051 subjects have been enrolled, respectively at the baseline, first, second and third follow-ups by now. At baseline, cars and motorcycles accounted for over 30% and 25% of RTIs. At first follow-up, 27% of participants were pedestrians engaged mostly in car crashes. Around a fourth of injuries were single injuries. Car occupants were injured in 40% of collisions. DISCUSSION: The study provides an opportunity to investigate physical-psychosocial outcomes of RTIs, predictors and patterns at follow-up phases postinjury through longitudinal assessments, to provide advocates for evidence-based safety national policy-making.


Subject(s)
Pedestrians , Wounds and Injuries , Accidents, Traffic , Humans , Motorcycles , Prospective Studies , Quality of Life , Wounds and Injuries/epidemiology
8.
Emerg Med Australas ; 34(5): 744-750, 2022 10.
Article in English | MEDLINE | ID: covidwho-1784562

ABSTRACT

OBJECTIVE: This study aimed to examine patterns of injury, the impact of these injuries on patients and identification of potentially modifiable contributing factors through industry regulation reforms and education. METHODS: Food delivery rider (FDR)-related presentations to the Royal Brisbane and Women's Hospital Emergency and Trauma Centre for a year from September 2020 were identified. Data collected included patient and incident demographics: time, type and location of injuries, investigations and care required, length of stay, admission requirements and follow up. RESULTS: The cohort included 81.8% male with a mean age of 25.2 years. Most injuries occurred on the road from a collision with a vehicle. The most common injury was fractures. Incidence increased on weekends and during the evening. More than half the cohort were admitted to hospital. Only 22.7% of patients were eligible for workers compensation and less than half were covered by Medicare. The majority (72.7%) of cases involved non-resident riders from other countries. CONCLUSION: The majority of FDRs presenting with injuries are not Australian citizens and less than half were Medicare eligible potentially contributing to inadequate access to care especially fracture follow up. There were spikes in injuries occurring at night, weekends and during periods of pandemic associated lockdowns demonstrating an increased usage of delivery services during these times. Results highlight injury patterns experienced by delivery riders and potentially modifiable risk factors for this rapidly growing area of employment within the gig economy.


Subject(s)
Fractures, Bone , Wounds and Injuries , Accidents, Traffic , Adult , Aged , Emergency Service, Hospital , Female , Fractures, Bone/epidemiology , Fractures, Bone/etiology , Head Protective Devices , Humans , Male , Medicare , Motorcycles , Risk Factors , United States , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology
9.
Medicine (Baltimore) ; 101(2): e28567, 2022 Jan 14.
Article in English | MEDLINE | ID: covidwho-1625627

ABSTRACT

ABSTRACT: Gyeonggi-do (Gyeonggi province) has the second highest number of coronavirus disease (COVID-19) cases in the Republic of Korea after Seoul, with approximately 25% of the COVID-19 patients as of January 2021. Our center is a level I trauma center located in south Gyeonggi-do, and we aimed to evaluate whether the characteristics of trauma patients changed after the COVID-19 pandemic.We retrospectively reviewed the trauma patients registered with the Korea Trauma Database of the Center from February 2019 to January 2021. The patients were dichotomized into pre-coronavirus disease (pre-COVID) and coronavirus disease (COVID) groups, and their trauma volumes, injury characteristics, intentionality, and outcomes were compared.A total of 2628 and 2636 patients were included in the pre-COVID and COVID groups, respectively. During the COVID-19 period, motorcycle accidents, bicycle accidents, and penetrating injury cases increased, and pedestrian traffic accidents, slips, and injury by machines decreased. The average daily number of patients in the COVID group was lower in March (5.6 ±â€Š2.6/day vs 7.2 ±â€Š2.4/day, P = .014) and higher in September (9.9 ±â€Š3.2/day vs 7.7 ±â€Š2.0/day, P = .003) compared to the pre-COVID group. The COVID group also had a higher ratio of direct admissions (67.5% vs 57.2%, P < .001), proportion of suicidal patients (4.1% vs 2.7%, P = .005), and injury severity scores (14 [9-22] vs 12 [4-22], P < .001) than the pre-COVID group. The overall mortality (4.7% vs 4.9%, P = .670) and intensive care unit length of stay (2 [0-3] days vs 2 [0-4] days, P = .153) was not different between the 2 groups.Although the total number of patients did not change, the COVID-19 pandemic affected the number of monthly admissions and the injury mechanisms changed. More severely injured patients were admitted directly to the trauma center.


Subject(s)
COVID-19 , Patient Admission/statistics & numerical data , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , Adult , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Republic of Korea/epidemiology , Retrospective Studies , SARS-CoV-2 , Wounds and Injuries/diagnosis , Wounds and Injuries/therapy
10.
J Surg Res ; 272: 139-145, 2022 04.
Article in English | MEDLINE | ID: covidwho-1620890

ABSTRACT

BACKGROUND: In the age of COVID-19 and enforced social distancing, changes in patterns of trauma were observed but poorly understood. Our aim was to characterize traumatic injury mechanisms and acuities in 2020 and compare them with previous years at our level I trauma center. MATERIAL AND METHODS: Patients with trauma triaged in 2016 through 2020 from January to May were reviewed. Patient demographics, level of activation (1 versus 2), injury severity score, and mechanism of injury were collected. Data from 2016 through 2019 were combined, averaged by month, and compared with data from 2020 using chi-squared analysis. RESULTS: During the months of interest, 992 patients with trauma were triaged in 2020 and 4311 in 2016-2019. The numbers of penetrating and level I trauma activations in January-March of 2020 were similar to average numbers for the same months during 2016 through 2019. In April 2020, there was a significant increase in the incidence of penetrating trauma compared with the prior 4-year average (27% versus 16%, P < 0.002). Level I trauma activations in April 2020 also increased, rising from 17% in 2016 through 2019 to 32% in 2020 (P < 0.003). These findings persisted through May 2020 with similarly significant increases in penetrating and high-level trauma. CONCLUSIONS: In the months after the initial spread of COVID-19, there was a perceptible shift in patterns of trauma. The significant increase in penetrating and high-acuity trauma may implicate a change in population dynamics, demanding a need for thoughtful resource allocation at trauma centers nationwide in the context of a global pandemic.


Subject(s)
COVID-19 , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , COVID-19/epidemiology , Humans , Injury Severity Score , Pandemics , Retrospective Studies , SARS-CoV-2
11.
Clin Radiol ; 77(3): 231-235, 2022 03.
Article in English | MEDLINE | ID: covidwho-1568610

ABSTRACT

AIM: To follow-up previous work evaluating incidental findings of COVID-19 signs on computed tomography (CT) images of major trauma patients to include the second wave prior to any major effects from vaccines. MATERIALS AND METHODS: The study population included all patients admitted following major trauma between 1 January 2020 and 28 February 2021 with CT including the lungs (n=1776). Major trauma patients admitted pre-COVID-19 from alternate months from January 2019 to November 2019 comprised a control group (n=837). The assessing radiologists were blinded to the time period and used double reading in consensus to determine if the patient had signs of COVID-19. Lung appearances were classified as no evidence of COVID-19, minor signs, or major signs. RESULTS: The method successfully tracked the second wave of the COVID-19 pandemic in London. The estimated population affected by the disease based on those with major signs was similar to estimates of the proportion of the population in London with antibodies (around 30% by end February 2021) and the total of major and minor signs produced a much higher figure of 68%, which may include all those with both antibody and just T-cell responses. CONCLUSIONS: Incidental findings on CT from major trauma patients may provide a novel and sensitive way of tracking the virus. It is recommended that all major trauma units include a simple question on signs of COVID-19 to provide an early warning system for further waves.


Subject(s)
COVID-19/epidemiology , Lung/diagnostic imaging , Tomography, X-Ray Computed , Wounds and Injuries/diagnostic imaging , Wounds and Injuries/epidemiology , Aged, 80 and over , COVID-19/diagnostic imaging , Comorbidity , Female , Humans , Incidental Findings , London/epidemiology , Male , Middle Aged , Pandemics , Prevalence , United Kingdom/epidemiology
12.
Ann R Coll Surg Engl ; 104(6): 437-442, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1542157

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has led to reconfiguration of healthcare resources to manage increased demand for acute hospital beds and intensive care places. Concerns were raised regarding continuing provision of critical care for non-COVID patients during the pandemic. The aim of this study was to assess the impact of the COVID-19 pandemic on patients admitted with major trauma (Injury Severity Score >15) across the four Level 1 trauma centres in London. METHODS: Data were collected from all four major trauma centres (MTCs) in London using the Trauma Audit and Research Network database and from local databases at each centre. A 2-month period from 5 March to 5 May 2020 was selected and the same period during 2019 was used to compare changes due to the pandemic. RESULTS: There was a 31% decrease in overall number of patients presenting to the four MTCs during the COVID-19 period compared with 2019. There was no difference in patient demographics or mechanism of injury between the two periods. Sports-related injuries and proportion of self-presentation to hospital were reduced slightly during the pandemic, although the differences were not statistically significant. The mortality rate and association between mortality and injury severity were similar. Proportion of patients requiring intensive care unit facilities also did not change. CONCLUSION: Despite diversion of critical care resources to deal with COVID-related admissions, we did not observe a change in mortality rate or proportion of severely injured patients requiring critical care. Our results suggest London MTCs were able to provide their usual standard of care for critically injured major trauma (Injury Severity Score >15) patients during the pandemic.


Subject(s)
COVID-19 , Wounds and Injuries , COVID-19/epidemiology , Humans , Injury Severity Score , London/epidemiology , Pandemics , Retrospective Studies , Trauma Centers , Wounds and Injuries/epidemiology , Wounds and Injuries/therapy
13.
BMC Emerg Med ; 21(1): 102, 2021 09 09.
Article in English | MEDLINE | ID: covidwho-1533244

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had profound effects on the utilization of health care services, including Emergency Medical Services (EMS). Social distancing measures taken to prevent the spread of the disease have greatly affected the functioning of societies and reduced or halted many activities with a risk of injury. The aim of this study was to report the effects of lockdown measures on trauma-related EMS calls in the Finnish capital area. METHODS: We conducted a retrospective cohort study of all EMS calls in the Helsinki University Hospital (HUH) catchment area between 1 January and 31 July 2020. Calls were identified from the HUH EMS database. Calls were grouped into pre-lockdown, lockdown, and post-lockdown periods according to the restrictions set by the Finnish government and compared to the mean number of calls for the corresponding periods in 2018 and 2019. Statistical comparisons were performed using Mann-Whitney U-test for weekly numbers and percentages. RESULTS: During the study period there was a total of 70,705 EMS calls, of which 14,998 (21.2%) were related to trauma; 67,973 patients (median age 61.6 years; IQR 35.3-78.6) were met by EMS. There was no significant change in the weekly number of total or trauma-related EMS calls during the pre-lockdown period. During the lockdown period, the number of weekly total EMS calls was reduced by 12.2% (p = 0.001) and the number of trauma-related calls was reduced by 23.3% (p = 0.004). The weekly number of injured patients met by EMS while intoxicated with alcohol was reduced by 41.8% (p = 0.002). During the post-lockdown period, the number of total and trauma-related calls and the number of injured patients intoxicated by alcohol returned to previous years' levels. CONCLUSIONS: The COVID-19 pandemic and social distancing measures reduced the number of trauma-related EMS calls. Lockdown measures had an especially significant effect on the number of injured patients intoxicated by alcohol met by the EMS. TRIAL REGISTRATION: Not applicable.


Subject(s)
COVID-19 , Emergency Medical Services , Wounds and Injuries/epidemiology , Communicable Disease Control , Emergency Medical Services/statistics & numerical data , Finland/epidemiology , Humans , Middle Aged , Pandemics , Retrospective Studies
14.
Arch Dis Child ; 106(11): 1050-1055, 2021 11.
Article in English | MEDLINE | ID: covidwho-1501685

ABSTRACT

BACKGROUND: Globally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5-24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited. METHODS: A new model of injury surveillance for use in emergency departments in Nepal was designed and piloted. Data from patients presenting with injuries were collected prospectively over 12 months and used to describe the epidemiology of paediatric injury presentations. RESULTS: The total number of children <18 years of age presenting with injury was 2696, representing 27% of all patients presenting with injuries enrolled. Most injuries in children presenting to the emergency departments in this study were unintentional and over half of children were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with poisonings, burns and drownings presenting proportionately less often. Over half of injuries were cuts, bites and open wounds. In-hospital child mortality from injury was 1%. CONCLUSION: Injuries affecting children in Nepal represent a significant burden. The data on injuries observed from falls, road traffic injuries and injuries related to animals suggest potential areas for injury prevention. This is the biggest prospective injury surveillance study in Nepal in recent years and supports the case for using injury surveillance to monitor child morbidity and mortality through improved data.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Global Burden of Disease/economics , Public Health Surveillance/methods , Wounds and Injuries/epidemiology , Accidental Falls/statistics & numerical data , Accidents, Traffic/statistics & numerical data , Adolescent , Animals , Bites and Stings/epidemiology , Burns/epidemiology , Child , Child, Preschool , Drowning/epidemiology , Emergency Service, Hospital/trends , Female , Humans , Male , Nepal/epidemiology , Poisoning/epidemiology , Prospective Studies , Trauma Severity Indices , Wounds and Injuries/mortality , Wounds and Injuries/prevention & control
15.
BMC Pediatr ; 21(1): 422, 2021 09 24.
Article in English | MEDLINE | ID: covidwho-1438263

ABSTRACT

BACKGROUND: To explore the characteristics of unintentional childhood-injury during the COVID-19 pandemic and assess the association of unintentional-injury with maternal emotional status. METHODS: A cross-sectional survey was conducted with a convenience sample of 1300 children under 12-years-old from 21 schools (including nurseries/ kindergartens/ primary schools) in Wuhan and Shanghai during March to April 2020, and the mothers completed questionnaires online. Self-rating Depression/Anxiety Scales were used to evaluate maternal emotional status, questions on child unintentional-injury were based on the International-Statistical-Classification-of-Diseases-and-Related-Health-Problems-version-10 (ICD-10), and a total of 11 kinds of unintentional injuries were inquired. Information on socio-demographic and family-background factors was also collected. RESULTS: The children of 0-4, 5-9, and 10-12 years accounted for 29.2, 55.2 and 15.6%, respectively, the unintentional-injury rates were 10.29, 4.18 and 3.45%, respectively (P < 0.001), and boys had higher rates than girls. The three leading causes included "being struck by/against", falls and animal bites (traffic-injury accounted for a small proportion). Lower maternal educational, living in suburban/rural (vs. urban) areas, grandparents (vs. mothers) being main caregivers, more child exposure to secondhand smoke, close relatives being suspected/ confirmed COVID-19 cases were associated with a higher risk of child unintentional-injury. After adjusting for related confounders, higher maternal depression levels were associated with a higher risk of unintentional injury. CONCLUSIONS: The characteristics of unintentional childhood injury were different from those in non-pandemic periods. The main causes, risk factors and the association of unintentional injury with maternal depression deserve attention for development of effective measures for preventing children from unintentional injury during COVID-19 pandemic.


Subject(s)
COVID-19 , Wounds and Injuries , Child , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Mothers , Pandemics , Risk Factors , SARS-CoV-2 , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology
16.
West J Emerg Med ; 22(5): 1060-1066, 2021 Sep 02.
Article in English | MEDLINE | ID: covidwho-1405511

ABSTRACT

INTRODUCTION: Very little is known about the effects of the novel coronavirus (COVID-19) pandemic and its associated social distancing practices on trauma presentations to the emergency department (ED). This study aims to assess the impact of a city-wide stay at home order on the volume, type, and outcomes of traumatic injuries at urban EDs. METHODS: The study was a retrospective chart review of all patients who presented to the ED of an urban Level I Trauma Center and its urban community affiliate in the time period during the 30 days before the institution of city-wide shelter-in-place (preSIP) order and 60 days after the shelter-in-place (SIP) order and the date-matched time periods in the preceding year. Volume and mechanism of traumatic injuries were compared using paired T-tests. RESULTS: There was a significant decrease in overall ED volume. The volume of certain blunt trauma presentations (motor vehicle collisions) during the first 60 days of SIP compared to the same period from the year prior also significantly decreased. Importantly, the volume of penetrating injuries, including gunshot wounds and stab wounds, did not differ for the preSIP and SIP periods when compared to the prior year. The mortality of traumatic injuries was also unchanged during the SIP comparison period. CONCLUSION: While there were significant decreases in visits to the ED and overall trauma volume, penetrating trauma, including gun violence, and other severe traumatic injuries remain a public health crisis that affects urban communities despite social distancing recommendations enacted during the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Emergency Service, Hospital/statistics & numerical data , Pandemics/prevention & control , Quarantine , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , COVID-19/epidemiology , Emergency Service, Hospital/trends , Humans , Retrospective Studies , SARS-CoV-2 , Urban Population
17.
Swiss Med Wkly ; 151(33-34)2021 08 27.
Article in English | MEDLINE | ID: covidwho-1399509

ABSTRACT

INTRODUCTION: The COVID-19 pandemic and the associated restrictions may have modified the activities of the Swiss population and thus altered trauma patterns. MATERIALS AND PATIENTS: All adult patients with major trauma admitted to our institution in 2019 and 2020 were assessed using the Injury Severity Score (ISS), by body region involved, type of injury, age, admission to an intensive care unit and 30-day mortality. RESULTS: In 2020, 454 patients with major trauma were admitted to our institution, 17% fewer than in the previous year. The drop in the number of major trauma patients proceeded with and overlapped both the first and second peaks in incidence of the pandemic and the associated restrictions. The median ISS was higher in 2020 (25, interquartile range [IQR] 17-26.5) than in 2019 (22, IQR 16-26, p = 0.04). There were no significant differences in body region involved, type of injury or age (p >0.05). In 2020, a higher percentage of patients were admitted to an intensive care unit (86.5% vs 77.7%, p <0.001) and died within 30 days (8.8% vs 5.0%, p = 0.015). The 30-day mortality was higher in 2020 than in 2019, with an odds ratio of 1.80 (95% confidence interval 1.04-3.10, p= 0.036) after adjustment for the following potential confounders: ISS, age, gender and type of injury. CONCLUSION: In the first year of the COVID-19 pandemic, fewer patients with major trauma were admitted to our institution. However, the patients admitted were more severely injured and more often died within 30 days. Understanding the differences in injury patterns and admissions in major trauma patients under special conditions - such as a pandemic - could help to allocate rare resources adequately.


Subject(s)
COVID-19 , Wounds and Injuries , Adult , Cohort Studies , Humans , Injury Severity Score , Pandemics , Retrospective Studies , SARS-CoV-2 , Switzerland/epidemiology , Trauma Centers , Wounds and Injuries/epidemiology
18.
PLoS One ; 16(3): e0248162, 2021.
Article in English | MEDLINE | ID: covidwho-1394534

ABSTRACT

MAVIE is a web-based prospective cohort study of Home, Leisure, and Sports Injuries with a longitudinal follow-up of French general population volunteers. MAVIE participants are voluntary members of French households, including overseas territories. Participation in the cohort involves answering individual and household questionnaires and relevant exposures and prospectively reporting injury events during the follow-up. Recruitment and data collection have been in progress since 2014. The number of participants as of the end of the year 2019 was 12,419 from 9,483 households. A total of 8,640 participants provided data during follow-up. Respondents to follow-up were composed of 763 children aged 0-14, 655 teenagers and young adults aged 15-29, 6,845 adults, and 377 people aged 75 or more. At the end of the year 2019, 1,698 participants had reported 2,483 injury events. Children, people aged 50 and more, people with poor self-perceived physical and mental health, people who engage in sports activities, and people with a history of injury during the year before recruitment were more likely to report new injuries. An interactive mobile/web application (MAVIE-Lab) was developed to help volunteers decide on personalized measures to prevent their risks of HLIs. The available data provides an opportunity to analyse multiple exposures at both the individual and household levels that may be associated with an increased risk of trauma. The ongoing analysis includes HLI incidence estimates, the determination of health-related risk factors, a specific study on the risk of home injury, another on sports injuries, and an analysis of the role of cognitive skills and mind wandering. Volunteers form a community that constitutes a population laboratory for preventative initiatives.


Subject(s)
Accidents, Home/statistics & numerical data , Athletic Injuries/epidemiology , Leisure Activities , Wounds and Injuries/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , France/epidemiology , Health Status , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Middle Aged , Mobile Applications , Prospective Studies , Risk Factors , Surveys and Questionnaires , Wounds and Injuries/etiology , Young Adult
19.
Accid Anal Prev ; 162: 106391, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1384788

ABSTRACT

The current study aims to investigate the impact of the COVID-19 pandemic on road traffic collisions, fatalities, and injuries using time series analyses. To that aim, a database containing road collisions, fatalities, and slight injuries data from Greece were derived from the Hellenic Statistical Authority (HSA) and covered a ten-year timeframe (from January 2010 to August 2020. The chosen time period contained normal operations, as well as the period of the first COVID-19-induced lockdown period in Greece. Three different Seasonal Autoregressive Integrated Moving Average (SARIMA) time series models were implemented in order to compare the observed measurements to forecasted values that were intended to depict assumed conditions; namely, without the appearance of the COVID-19 pandemic. Modelling results revealed that the total number of road collisions, fatalities, and slightly injured were decreased, mainly due to the sharp traffic volume decrease. However, the percentage reduction of the collision variables and traffic volume were found to be disproportionate, which probably indicates that more collisions occurred with regard to the prevailing traffic volume. An additional finding is that fatalities and slightly injured rates were significantly increased during the lockdown period and the subsequent month. Overall, it can be concluded that a worse performance was identified in terms of road safety. Since subsequent waves of COVID-19 cases and other pandemics may reappear in the future, the outcomes of the current study may be exploited for the improvement of road safety from local authorities and policymakers.


Subject(s)
COVID-19 , Wounds and Injuries , Accidents, Traffic , Communicable Disease Control , Greece/epidemiology , Humans , Pandemics , SARS-CoV-2 , Wounds and Injuries/epidemiology
20.
Injury ; 51(6): 1243-1244, 2020 06.
Article in English | MEDLINE | ID: covidwho-1382432
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