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1.
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
2.
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
3.
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
4.
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
5.
J Surg Res ; 266: 62-68, 2021 10.
Article in English | MEDLINE | ID: covidwho-1226312

ABSTRACT

OBJECTIVE: To investigate whether any specific acute care surgery patient populations are associated with a higher incidence of COVID-19 infection. BACKGROUND: Acute care providers may be exposed to an increased risk of contracting the COVID-19 infection since many patients present to the emergency department without complete screening measures. However, it is not known which patients present with the highest incidence. METHODS: All acute care surgery (ACS) patients who presented to our level I trauma center between March 19, 2020, and September 20, 2020 and were tested for COVID-19 were included in the study. The patients were divided into two cohorts: COVID positive (+) and COVID negative (-). Patient demographics, type of consultation (emergency general surgery consults [EGS], interpersonal violence trauma consults [IPV], and non-interpersonal violence trauma consults [NIPV]), clinical data and outcomes were analyzed. Univariate and multivariate analyses were used to compare differences between the groups. RESULTS: In total, 2177 patients met inclusion criteria. Of these, 116 were COVID+ (5.3%) and 2061 were COVID- (94.7%). COVID+ patients were more frequently Latinos (64.7% versus 61.7%, P = 0.043) and African Americans (18.1% versus 11.2%, P < 0.001) and less frequently Caucasian (6.0% versus 14.1%, P < 0.001). Asian/Filipino/Pacific Islander (7.8% versus 7.2%, P = 0.059) and Native American/Other/Unknown (3.4% versus 5.8%, P = 0.078) groups showed no statistical difference in COVID incidence. Mortality, hospital and ICU lengths of stay were similar between the groups and across patient populations stratified by the type of consultation. Logistic regression demonstrated higher odds of COVID+ infection amongst IPV patients (OR 2.33, 95% CI 1.62-7.56, P < 0.001) compared to other ACS consultation types. CONCLUSION: Our findings demonstrate that victims of interpersonal violence were more likely positive for COVID-19, while in hospital outcomes were similar between COVID-19 positive and negative patients.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/epidemiology , Violence/statistics & numerical data , Wounds and Injuries/epidemiology , Adult , Aged , COVID-19/diagnosis , COVID-19/virology , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Risk Assessment/statistics & numerical data , Risk Factors , SARS-CoV-2/isolation & purification , Trauma Centers/statistics & numerical data , Wounds and Injuries/etiology , Wounds and Injuries/therapy
6.
Am J Crit Care ; 30(4): 287-293, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1207827

ABSTRACT

BACKGROUND: Caring for patients with COVID-19 requires wearing a full set of personal protective equipment (PPE) to avoid contamination. Personal discomfort has been associated with use of PPE, and anecdotal reports describe pressure injuries related to wearing PPE. OBJECTIVES: To investigate the occurrence of device-related pressure injuries due to wearing PPE among Italian nurses caring for patients with COVID-19 in critical care settings. METHODS: This descriptive study used an online survey investigating both the demographic characteristics of respondents and complications related to wearing PPE, including the development of pressure injuries. RESULTS: A total of 266 nurses throughout Italy completed the survey; 32% of respondents were men. Nurses' median age was 36 years (range 22-59 years), and the median time spent working in their current clinical setting (an intensive care or high-dependency unit) was 3 years (range 0-32 years). Personal protective equipment was worn for a median duration of 5 hours (range 2-12 hours). While wearing PPE, 92.8% of nurses experienced pain and 77.1% developed device-related pressure injuries, mainly on the nose, ears, and forehead. Pain was more frequent among nurses with such injuries. Transparent dressings, emollient cream, and no dressing were associated with development of device-related pressure injury. CONCLUSIONS: Pressure injuries related to PPE represent an important adverse effect for nurses caring for patients with COVID-19. This topic deserves study to determine adequate solutions for preventing and treating such injuries and their potential influence on nurses' work tolerance.


Subject(s)
COVID-19/nursing , Intensive Care Units , Personal Protective Equipment/adverse effects , Wounds and Injuries/etiology , Adult , COVID-19/epidemiology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pressure , SARS-CoV-2 , Surveys and Questionnaires , Time Factors
7.
J Trauma Acute Care Surg ; 90(4): 700-707, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1203800

ABSTRACT

BACKGROUND: The large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses. METHODS: A single-center interrupted time-series analysis was performed to identify associations of shelter-in-place with trauma volume, injury mechanisms, and patient demographics in San Francisco, California. To control for short-term trends in trauma epidemiology, weekly level data were analyzed 6 months before shelter-in-place. To control for long-term trends, monthly level data were analyzed 5 years before shelter-in-place. RESULTS: Trauma volume decreased by 50% in the week following shelter-in-place (p < 0.01), followed by a linear increase each successive week (p < 0.01). Despite this, trauma volume for each month (March-June 2020) remained lower compared with corresponding months for all previous 5 years (2015-2019). Pediatric trauma volume showed similar trends with initial decreases (p = 0.02) followed by steady increases (p = 0.05). Reductions in trauma volumes were due entirely to changes in nonviolent injury mechanisms, while violence-related injury mechanisms remained unchanged (p < 0.01). CONCLUSION: Although the shelter-in-place order was associated with an overall decline in trauma volume, violence-related injuries persisted. Delineating and addressing underlying factors driving persistent violence-related injuries during shelter-in-place orders should be a focus of public health efforts in preparation for future pandemic responses. LEVEL OF EVIDENCE: Epidemiological study, level III.


Subject(s)
COVID-19 , Disease Transmission, Infectious/prevention & control , Physical Abuse/statistics & numerical data , Physical Distancing , Trauma Centers/statistics & numerical data , Wounds and Injuries , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Correlation of Data , Female , Humans , Interrupted Time Series Analysis , Male , Retrospective Studies , SARS-CoV-2 , San Francisco/epidemiology , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/therapy
8.
Eur J Trauma Emerg Surg ; 47(3): 665-675, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1195138

ABSTRACT

PURPOSE: In Dec 2019, COVID-19 was first recognized and led to a worldwide pandemic. The German government implemented a shutdown in Mar 2020, affecting outpatient and hospital care. The aim of the present article was to evaluate the impact of the COVID-19 shutdown on patient volumes and surgical procedures of a Level I trauma center in Germany. METHODS: All emergency patients were recorded retrospectively during the shutdown and compared to a calendar-matched control period (CTRL). Total emergency patient contacts including trauma mechanisms, injury patterns and operation numbers were recorded including absolute numbers, incidence proportions and risk ratios. RESULTS: During the shutdown period, we observed a decrease of emergency patient cases (417) compared to CTRL (575), a decrease of elective cases (42 vs. 13) and of the total number of operations (397 vs. 325). Incidence proportions of emergency operations increased from 8.2 to 12.2% (shutdown) and elective surgical cases decreased (11.1 vs. 4.3%). As we observed a decrease for most trauma mechanisms and injury patterns, we found an increasing incidence proportion for severe open fractures. Household-related injuries were reported with an increasing incidence proportion from 26.8 to 47.5% (shutdown). We found an increasing tendency of trauma and injuries related to psychological disorders. CONCLUSION: This analysis shows a decrease of total patient numbers in an emergency department of a Level I trauma center and a decrease of the total number of operations during the shutdown period. Concurrently, we observed an increase of severe open fractures and emergency operations. Furthermore, trauma mechanism changed with less traffic, work and sports-related accidents.


Subject(s)
COVID-19 , Infection Control/methods , Surgical Procedures, Operative , Trauma Centers , Wounds and Injuries , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Emergencies/epidemiology , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Female , Germany/epidemiology , Humans , Incidence , Male , Organizational Innovation , Retrospective Studies , SARS-CoV-2 , Surgical Procedures, Operative/methods , Surgical Procedures, Operative/statistics & numerical data , Trauma Centers/organization & administration , Trauma Centers/statistics & numerical data , Trauma Severity Indices , Wounds and Injuries/diagnosis , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/surgery
10.
Arch Pediatr ; 28(3): 249-251, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1118326

ABSTRACT

BACKGROUND: The first case of SARS-CoV-2 was detected in France in January 2020 and the government decided on national confinement from March 17 to May 11, 2020. Our aim was to analyze the incidence of pediatric emergency department (ED) visits and hospitalizations for traumatic injuries during this period. METHODS: Any visit with an ICD-10 discharge diagnosis code of burn, fracture, traumatic wound, or sprain/bruise contusion was recorded within the 2 weeks before (weeks 10 and 11) and during the confinement (weeks 12 and 19). The visits with the same ICD-10 discharge diagnosis code during similar weeks of the previous 2 years were also included. For each of those visits, the number of hospitalizations was counted. RESULTS: The number of recorded visits between week 10 and 19 in 2018, 2019, and 2020 was, respectively, 2657, 2625, and 1106 children. The average number of visits per day during the confinement (13±5) was significantly different from the average number of visits per day during the same weeks in 2018 and 2019 (38±8 vs. 39±9, P<0.0001). The average number of visits per day was significantly lower during confinement compared with 2018/2019 for three categories of diagnoses (P<0.0001) but not for burns (1.7 vs. 1.8, P=0.23). The average number of hospitalizations per day was significantly lower during the confinement than during 2018/2019 (1.6±1.3 vs. 2.6±1.8, P<0.0001). CONCLUSION: Confining children in an urban setting appears to decrease the incidence of injuries, except for burns. These data may be useful in reorganizing caregiver supervision and hospital units. These results will need to be consolidated in a multicenter study.


Subject(s)
COVID-19/prevention & control , Emergency Service, Hospital/trends , Health Policy , Quarantine , Urban Health/trends , Wounds and Injuries/epidemiology , Adolescent , Child , Child, Preschool , Female , Hospitalization/trends , Humans , Incidence , Infant , Infant, Newborn , Male , Paris/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/therapy
11.
Injury ; 52(3): 395-401, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1087000

ABSTRACT

PURPOSE: The aim of this study was to evaluate changes in both mechanism and diagnoses of injuries presenting to the orthopaedic department during this lockdown period, as well as to observe any changes in operative case-mix during this time. METHODS: A study period of twelve weeks following the introduction of the nationwide "lockdown period", March 23rd - June 14th, 2020 was identified and compared to the same time period in 2019 as a "baseline period". A retrospective analysis of all emergency orthopaedic referrals and surgical procedures performed during these time frames was undertaken. All data was collected and screened using the 'eTrauma' management platform (Open Medical, UK). The study included data from a five NHS Foundation Trusts within North West London. A total of 6695 referrals were included for analysis. RESULTS: The total number of referrals received during the lockdown period fell by 35.3% (n=2631) compared to the same period in 2019 (n=4064). Falls remained proportionally the most common mechanism of injury across all age groups in both time periods. The proportion sports related injuries compared to the overall number of injuries fell significantly during the lockdown period (p<0.001), however, the proportion of pushbike related accidents increased significantly (p<0.001). The total number of operations performed during the lockdown period fell by 38.8% (n=1046) during lockdown (n=1732). The proportion of patients undergoing operative intervention for Neck of Femur (NOF) and ankle fractures remained similar during both study periods. A more non-operative approach was seen in the management of wrist fractures, with 41.4% of injuries undergoing an operation during the lockdown period compared to 58.6% at baseline (p<0.001). CONCLUSION: In conclusion, the nationwide lockdown has led to a decrease in emergency orthopaedic referrals and procedure numbers. There has been a change in mechanism of injuries, with fewer sporting injuries, conversely, there has been an increase in the number of pushbike or scooter related injuries during the lockdown period. NOF fractures remained at similar levels to the previous year. There was a change in strategy for managing distal radius fractures with more fractures being treated non-operatively.


Subject(s)
Accidental Falls/statistics & numerical data , Accidents, Traffic/trends , Bicycling/injuries , COVID-19 , Orthopedic Procedures/trends , Referral and Consultation/trends , Wounds and Injuries/epidemiology , Adolescent , Adult , Aged , Arm Injuries/epidemiology , Arm Injuries/etiology , Arm Injuries/therapy , Athletic Injuries/epidemiology , Athletic Injuries/therapy , Child , Child, Preschool , Diagnosis-Related Groups , Female , Femoral Neck Fractures/epidemiology , Femoral Neck Fractures/surgery , Fractures, Bone/epidemiology , Fractures, Bone/etiology , Fractures, Bone/therapy , Fractures, Open/epidemiology , Fractures, Open/etiology , Fractures, Open/therapy , Humans , Infant , Infant, Newborn , Leg Injuries/epidemiology , Leg Injuries/etiology , Leg Injuries/therapy , London/epidemiology , Male , Middle Aged , SARS-CoV-2 , Trauma Centers , Wounds and Injuries/etiology , Wounds and Injuries/therapy , Wrist Injuries/epidemiology , Wrist Injuries/etiology , Wrist Injuries/therapy , Young Adult
12.
Eur J Trauma Emerg Surg ; 47(3): 637-645, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1070810

ABSTRACT

BACKGROUND: The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of "lockdown measures" and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma. METHODS: This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020-18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019-20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher's exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality. RESULTS: A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (p < 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables. CONCLUSION: Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.


Subject(s)
COVID-19 , Emergency Service, Hospital/statistics & numerical data , Infection Control , Surgical Procedures, Operative/statistics & numerical data , Wounds and Injuries , Accidental Falls/statistics & numerical data , Accidents, Traffic/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Infection Control/methods , Infection Control/organization & administration , Male , Middle Aged , SARS-CoV-2 , Trauma Severity Indices , United Kingdom/epidemiology , Wounds and Injuries/classification , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/surgery
13.
Wounds ; 32(11): 294-298, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-1063724

ABSTRACT

INTRODUCTION: Calciphylaxis is a rare, highly morbid pathological syndrome of vascular calcification and tissue necrosis. It is predominantly seen in patients with end-stage renal disease (ESRD) on chronic dialysis. There is no definitive standard of care for calciphylaxis, and the overall prognosis for patients, particularly those with ulcerated lesions, is bleak. One important role of wound care clinicians during the COVID-19 pandemic is to ensure that the continuity of care of an at-risk population is maintained while limiting the patient's potential exposure to the virus. Innovative therapies paired with alternative treatment sites of service are one such method. CASE REPORT: A 56-year-old female with ESRD on at-home peritoneal dialysis (PD) presented to the outpatient wound clinic with a punch biopsy-proven calciphylaxis lesion. Within days, state-wide "shelter-at-home" orders due to the COVID-19 pandemic went into effect. To prevent disruption in care and to minimize risk to the patient, the lesion was treated with bi-weekly self-application of a continuous topical oxygen therapy (cTOT) device paired with weekly telemedicine visits. The wound completely resolved after 9 weeks of topical oxygen therapy with no complications or device malfunctions. CONCLUSIONS: This case, to the authors' knowledge, is the first to document healing in a calciphylaxis wound with the use of cTOT. Topical oxygen therapy may be a beneficial adjunctive therapy in the treatment of wounds caused by calciphylaxis. Finding creative ways to navigate this current health care crisis is essential to help mitigate risk for vulnerable patients with advanced comorbidities.


Subject(s)
COVID-19/complications , Calciphylaxis/therapy , Oxygen/therapeutic use , Peritoneal Dialysis/adverse effects , Wounds and Injuries/therapy , Administration, Topical , Calciphylaxis/complications , Calciphylaxis/etiology , Female , Humans , Middle Aged , Oxygen/administration & dosage , Quarantine , Wound Healing , Wounds and Injuries/etiology
14.
Acta Orthop ; 92(3): 249-253, 2021 06.
Article in English | MEDLINE | ID: covidwho-1062816

ABSTRACT

Background and purpose - COVID-19 lockdowns have resulted in noteworthy changes in trauma admissions. We report and compare the incidence and characteristics of severe injuries (New Injury Severity Score [NISS] > 15) during the COVID-19 lockdown in Finland with earlier years.Methods - We retrospectively analyzed incidence rate, injury severity scores, injury patterns, and mechanisms of injury of all severely injured patients (NISS >15) in 4 Finnish hospitals (Tampere University Hospital, Kuopio University Hospital, Central Finland Hospital, Mikkeli Central Hospital) during the 11-week lockdown period (March 16-May 31, 2020) with comparison with a matching time period in earlier years (2016-2018). These 4 hospitals have a combined catchment area of 1,150,000 people or roughly one-fifth of the population of Finland.Results - The incidence rate of severe injuries during the lockdown period was 4.9/105 inhabitants (95% CI 3.7-6.4). The incidence rate of severe injuries during years 2016-2018 was 5.1/105 inhabitants (CI 3.9-6.5). We could not detect a significant incidence difference between the lockdown period and the 3 previous years (incidence rate difference -0.2 (CI -2.0 to 1.7). The proportion of traffic-related accidents was 55% during the lockdown period and 51% during previous years. There were no detectable differences in injury patterns. During the lockdown period, the mean age of patients was higher (53 years vs. 47 years, p = 0.03) and the rate of severely injured elderly patients (aged 70 or more) was higher (30% vs. 16%).Interpretation - Despite heavy social restrictions, the incidence of severe injuries during the lockdown period was similar to previous years. Notably, a decline in road use and traffic volumes did not reduce the number of severe traffic accidents. Although our data is compatible with a decrease of 2.0 to an increase of 1.7 severely injured patients per 105 inhabitants, we conclude that severely injured patients do not disappear even during pandemic and stabile hospital resources are needed to treat these patients.


Subject(s)
COVID-19 , Wounds and Injuries/epidemiology , Wounds, Nonpenetrating/epidemiology , Abbreviated Injury Scale , Abdominal Injuries/epidemiology , Abdominal Injuries/etiology , Accidental Falls/statistics & numerical data , Accidents, Traffic/statistics & numerical data , Adult , Age Distribution , Aged , Cohort Studies , Communicable Disease Control , Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/etiology , Extremities/injuries , Facial Injuries/epidemiology , Facial Injuries/etiology , Female , Finland/epidemiology , Humans , Incidence , Injury Severity Score , Intensive Care Units , Length of Stay/statistics & numerical data , Male , Middle Aged , Pelvis/injuries , Public Policy , Retrospective Studies , SARS-CoV-2 , Soft Tissue Infections/epidemiology , Soft Tissue Infections/etiology , Thoracic Injuries/epidemiology , Thoracic Injuries/etiology , Wounds and Injuries/etiology
16.
Eur J Trauma Emerg Surg ; 47(3): 703-711, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1029862

ABSTRACT

PURPOSE: The SARS-CoV-2 virus has disrupted global and local medical supply chains. To combat the spread of the virus and prevent an uncontrolled outbreak with limited resources, national lockdown protocols have taken effect in the Netherlands since March 13th, 2020. The aim of this study was to describe the incidence, type and characteristics of HEMS and HEMS-ambulance 'Lifeliner 1' dispatches during the initial phase of the COVID-19 pandemic compared to the same period one year prior. METHODS: A retrospective review of all HEMS and HEMS-ambulance 'Lifeliner 1' dispatches was performed from the start of Dutch nationwide lockdown orders from March 13th until May 13th, 2020 and the corresponding period one year prior. Dispatch-, operational-, patient-, injury-, and on-site treatment characteristics were extracted for analysis. In addition, the rate of COVID-19 positively tested HEMS personnel and the time physicians were unable to take call was described. RESULTS: During the initial phase of the COVID-19 pandemic, the HEMS and HEMS-ambulance was requested in 528 cases. One year prior, a total of 620 requests were received. The HEMS (helicopter and ambulance) was cancelled after deployment in 56.4% of the COVID-19 cohort and 50.7% of the historical cohort (P = 0.05). Incident location type did not differ between the two cohorts, specifically, there was no significant difference in the number of injuries that occurred at home in pandemic versus non-pandemic circumstances. Besides a decrease in the number of falls, the distribution of mechanisms of injury remained similar during the COVID-19 study period. There was no difference in self-inflicted injuries observed. Prehospital interventions remained similar during the COVID-19 pandemic compared to one year prior. Specifically, prehospital intubation did not differ between the two cohorts. The rate of COVID-19 positively tested HEMS personnel was 23.1%. Physicians who tested positive were unable to take call for a mean of 25 days (range 8-53). CONCLUSION: A decrease in the number of deployments and increase in the number of cancelled missions was observed during the COVID-19 study period. No major differences in operational- and injury characteristics were found for HEMS and HEMS-ambulance dispatches between the initial phase of the COVID-19 pandemic in the Netherlands and the same period one year prior. These findings highlight the importance of continued operability of the HEMS, even during pandemic circumstances. LEVEL OF EVIDENCE: III, retrospective comparative study.


Subject(s)
Air Ambulances , COVID-19 , Emergency Medical Services , Wounds and Injuries , Adult , Air Ambulances/organization & administration , Air Ambulances/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control/methods , Emergencies/epidemiology , Emergency Medical Dispatcher/statistics & numerical data , Emergency Medical Services/methods , Emergency Medical Services/statistics & numerical data , Emergency Medical Services/supply & distribution , Female , Humans , Male , Netherlands/epidemiology , Occupational Health/statistics & numerical data , Outcome and Process Assessment, Health Care , SARS-CoV-2 , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/therapy
17.
Health Promot Chronic Dis Prev Can ; 40(11-12): 336-341, 2020 12 09.
Article in English, French | MEDLINE | ID: covidwho-1029022

ABSTRACT

INTRODUCTION: Research has shown that during the 2003 SARS pandemic, emergency department (ED) visits among the pediatric population decreased. We set out to investigate if this was also true for injury-related ED visits during the COVID-19 pandemic. METHODS: Using data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), we looked at 28 years of injury-related ED visits at the Montreal Children's Hospital, a provincially designated Pediatric Trauma Centre. We compared data from a two-month period during the COVID-19 lockdown (16 March to 15 May) to the same period in previous years (1993-2019) to determine whether the 2020 decrease in ED visit numbers was unprecedented (i.e. a similar decrease had never occurred) for different age groups, nature of injuries, mechanisms and severity. RESULTS: The 2020 decrease was unprecedented across all age groups between 1993 and 2019. When compared with the 2015 to 2019 average, the decrease was smallest in children aged 2 to 5 years (a 35% decrease), and greatest in the group aged 12 to 17 years (83%). Motor vehicle collisions and sports-related injuries practically vanished during the COVID-19 lockdown. Surprisingly, more children aged 6 to 17 years presented with less urgent injuries during the COVID-19 lockdown than in previous years. CONCLUSION: As was the case with SARS in 2003, COVID-19 acted as a deterrent for pediatric ED visits. The lockdown in particular had a profound impact on injury-related visits. The de-confinement period will be monitored to determine the impact in both the short and the long term.


Subject(s)
COVID-19/epidemiology , Emergency Service, Hospital/statistics & numerical data , Wounds and Injuries/epidemiology , Accidents, Traffic/statistics & numerical data , Adolescent , Athletic Injuries/epidemiology , Child , Child, Preschool , Female , Hospitals, Pediatric/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Protective Factors , Quebec/epidemiology , SARS-CoV-2 , Wounds and Injuries/etiology
18.
Radiology ; 298(1): E38-E45, 2021 01.
Article in English | MEDLINE | ID: covidwho-991943

ABSTRACT

Background Intimate partner violence (IPV) is a global social and public health problem, but published literature regarding the exacerbation of physical IPV during the coronavirus disease 2019 (COVID-19) pandemic is lacking. Purpose To assess the incidence, patterns, and severity of injuries in IPV victims during the COVID-19 pandemic in 2020 compared with the prior 3 years. Materials and Methods The demographics, clinical presentation, injuries, and radiologic findings of patients reporting physical abuse arising from IPV during the statewide COVID-19 pandemic between March 11 and May 3, 2020, were compared with data from the same period for the past 3 years. Pearson χ2 and Fisher exact tests were used for analysis. Results A total of 26 victims of physical IPV from 2020 (mean age, 37 years ± 13 [standard deviation]; 25 women) were evaluated and compared with 42 victims of physical IPV (mean age, 41 years ± 15; 40 women) from 2017 to 2019. Although the overall number of patients who reported IPV decreased during the pandemic, the incidence of physical IPV was 1.8 times greater (95% CI: 1.1, 3.0; P = .01). The total number of deep injuries was 28 during 2020 versus 16 from 2017 to 2019; the number of deep injuries per victim was 1.1 during 2020 compared with 0.4 from 2017 to 2019 (P < .001). The incidence of high-risk abuse defined by mechanism was two times greater in 2020 (95% CI: 1.2, 4.7; P = .01). Patients who experienced IPV during the COVID-19 pandemic were more likely to be White; 17 (65%) victims in 2020 were White compared with 11 (26%) in the prior years (P = .007). Conclusion There was a higher incidence and severity of physical intimate partner violence (IPV) during the coronavirus disease 2019 (COVID-19) pandemic compared with the prior 3 years. These results suggest that victims of IPV delayed reaching out to health care services until the late stages of the abuse cycle during the COVID-19 pandemic. © RSNA, 2020.


Subject(s)
COVID-19 , Intimate Partner Violence/statistics & numerical data , Wounds and Injuries/epidemiology , Adult , Female , Humans , Incidence , Injury Severity Score , Male , Middle Aged , Retrospective Studies , United States/epidemiology , Wounds and Injuries/etiology , Young Adult
19.
Am Surg ; 87(5): 686-689, 2021 May.
Article in English | MEDLINE | ID: covidwho-966318

ABSTRACT

BACKGROUND: Over 28 million confirmed cases of COVID-19 have been reported to date, resulting in over 900 000 deaths. With an increase in awareness regarding the virus, the behavior of general population has changed dramatically. As activities such as driving and hospital presentation patterns have changed, our study aimed to assess the differences in trauma case variables before and during the COVID-19 pandemic. METHODS: Trauma data for the period of March 1st-June 15th were compared for the years 2015-2019 (pre-COVID) and 2020 (COVID). The data were analyzed across the following categories: injury severity score, injury mechanism, motor vehicle crashes (MVCs) vs. other blunt injuries, alcohol involvement, and length of hospital stay. RESULTS: The median injury severity score pre-COVID and during COVID was 9, representing no change. There was no difference in overall distribution of mechanism of injury; however, there was a significant decrease in the percentage of MVCs pre-COVID (36.39%) vs. COVID (29.6%, P < .05). Alcohol was significantly more likely to be involved in trauma during COVID-19 (P < .05). The mean hospital stay increased from 3.87-5.4 days during COVID-19 (P < .05). DISCUSSION: We saw similar results to prior studies in terms of there being no change in trauma severity. Our observation that motor vehicle collisions have decreased is consistent with current data showing decreased use of motor vehicles during the pandemic. We also observed an increase in alcohol-related cases which are consistent with the reported changes in alcohol consumption since the pandemic began.


Subject(s)
COVID-19 , Trauma Centers/trends , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , COVID-19/epidemiology , COVID-19/prevention & control , Georgia/epidemiology , Humans , Injury Severity Score , Length of Stay/statistics & numerical data , Pandemics/prevention & control , Retrospective Studies , Risk Factors , Wounds and Injuries/diagnosis , Wounds and Injuries/therapy
20.
Chin J Traumatol ; 24(1): 1-4, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-956981

ABSTRACT

The year 2020 is an extremely unusual year. The world lost more than one million lives due to the attack of COVID-19. Economic production has been greatly reduced, and daily activities are largely restricted. Luckily the work of Chinese Journal of Traumatology (CJTEE) has not been adversely affected. 2020 is a harvest year for the journal, which (1) was included in the high-quality academic journals by China Association for Science and Technology; (2) cover of each issue is newly designed; (3) submission increased by about 60% with more countries and regions covered; (4) usage in the ScienceDirect database exceeded a million; (5) the CiteScore rises to more than 2.0 the first time. This study reviewed the articles published in the year 2020 by CJTEE.


Subject(s)
COVID-19 , Periodicals as Topic , Science/organization & administration , Societies, Scientific/organization & administration , Technology/organization & administration , Traumatology/organization & administration , Wounds and Injuries , China , Humans , Time Factors , Wounds and Injuries/etiology
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