Retrospective Examination of Trauma Patients Referred to the Emergency Department During the COVID-19 Pandemic Restriction Period

Abstract

Aim: The COVID-19 epidemic has affected the entire health system worldwide. Along with many countries, restrictions have been introduced in our country. We aim to examine the characteristics of trauma patients who applied to the emergency department during the pandemic lockdown. Material and Methods: We compared the clinical features of the trauma-related admissions in the three month periods (1/3/2020 – 1/6/2020) with the pandemic lockdown and the same period of the previous year (1/3/2019 - 1/6/2019). Demographic characteristics, mechanism of injury, need for hospitalization, and patient outcomes were evaluated. Results: During the pandemic lockdown period, the patient admission rate decreased by 17.25% compared to the previous year. This decrease was found to be significant, especially for those under 85 years old (<0.05). While there was a significant decrease (<0.05) in cases of forensic cases and traffic accidents in emergency service admissions. There was no significant difference in hospitalizations due to traffic accidents (p=0.257). Patients were mostly hospitalized in the Orthopedics department. There was no statistically significant difference before and during the pandemic (p=0.831). Conclusion: Similar to the number of emergency service applications during the pandemic period, there was a decrease in applications due to trauma. The absence of significant differences in specific patient groups and hospitalizations should be considered in pandemic planning.

Keywords

• Pandemic
• lockdown
• COVID-19
• trauma
• emergency department

Supporting Institution

Destekleyen kurum bulunmamaktadır.

Ethical Statement

Karar No: 21-3T/44

COVID-19 Pandemi Kısıtlama Döneminde Acil Servise Başvuran Travma Hastalarının Geriye Dönük İncelenmesi

Abstract

Amaç: COVID-19 salgını dünya genelinde tüm sağlık sistemini etkilemiştir. Birçok ülke ile birlikte, ülkemizde de kısıtlamalar getirilmiştir. Bu çalışma, sokağa çıkma yasağının olduğu dönemlerde acil servise başvuran travma hastalarının özelliklerini incelemeyi amaçlamaktadır. Gereç ve Yöntem: Kısıtlamaların yoğun olduğu üç aylık period (1/3/2020 – 1/6/2020) ile bir önceki yılın aynı periyodundaki (1/3/2019 - 1/6/2019) travma nedenli başvuruların klinik özellikleri karşılaştırıldı. Demografik özellikleri, yaralanma mekanizması, hastaneye yatış ihtiyacı ve hasta sonlanımları değerlendirildi. Bulgular: Pandeminin kısıtlama döneminde bir öncesi yıla göre hasta başvuru oranında % 17,25’lik düşüş belirlendi. Bu düşüşün özellikle 85 yaş ve altında anlamlı olduğu bulundu (<0,05). Acil servis başvurularında adli vaka ve trafik kazası ile başvurularda anlamlı azalma (<0,05) saptanırken trafik kazalarına bağlı yatışlarda anlamlı fark saptanmadı (p=0,257). Hastaneye yatışlar en sık Ortopedi bölümüne olurken bu durum pandemi öncesi ve sırasında anlamlı farklılık oluşturmadı (p=0,831). Sonuç: Pandemi döneminde acil servis başvuru sayılarına benzer şekilde travma nedenli başvurularda da azalma yaşanmıştır. Özellikli hasta grupları ve hastaneye yatışlarda anlamlı fark saptanmaması pandemi planlamalarında göz önünde bulundurulmalıdır.

Keywords

• Pandemi
• kısıtlama dönemi
• COVID 19
• travma
• acil servis

Supporting Institution

Destekleyen kurum bulunmamaktadır.

Ethical Statement

Karar No: 21-3T/44

References

1. Chiba H, Lewis M, Benjamin E.R, et al. "Safer at home": The effect of the COVID-19 lockdown on epidemiology, resource utilization, and outcomes at a large urban trauma center. The journal of trauma and acute care surgery 202;190(4):708–713. https://doi.org/10.1097/TA.0000000000003061
2. Nuñez JH, Sallent A, Lakhani K, et al. Impact of the COVID-19 Pandemic on an Emergency Traumatology Service: Experience at a Tertiary Trauma Centre in Spain. Injury 2020;51:1414–8. doi:10.1016/j.injury.2020.05.016
3. T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, COVID-19 (SARSCoV-2 Enfeksiyonu) Genel Bilgiler, Epidemiyoloji ve Tanı, Bilimsel Danışma Kurulu Çalışması. https://covid19.saglik.gov.tr/Eklenti/38597/0/ Erişim tarihi:15.12.2022
4. Smith CM, Graffeo CS. Regional impact of Hurricane Isabel on emergency departments in Coastal Southeastern Virginia. Academic Emergency Medicine 2005;12:1201–5.doi:10.1197/j.aem.2005.06.024
5. Almeida A, Eusébio M, Almeida J, et al. The impact of the lisbon football derby on the profile of emergency department admissions. Acta Medica Portuguesa 2014;27:700–3. doi:10.20344/amp.4980
6. Correia JC, Braillard O, Combescure C, et al. Admission rates in emergency departments in Geneva during tennis broadcasting: A retrospective study. BMC Emergency Medicine 2018;18:1–9. doi:10.1186/s12873-018-0209-y
7. Kuitunen I, Ponkilainen VT, Launonen AP, et al. The effect of national lockdown due to COVID-19 on emergency department visits. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2020;28:1–8. doi:10.1186/s13049-020-00810-0
8. Nourazari S, Davis SR, Granovsky R, et al. Decreased hospital admissions through emergency departments during the COVID-19 pandemic. American Journal of Emergency 2021;42:203-210 doi:10.1016/j.ajem.2020.11.029

9. Rajput K, Sud A, Rees M, et al. Epidemiology of trauma presentations to a major trauma centre in the North West of England during the COVID-19 level 4 lockdown. European Journal of Trauma and Emergency Surgery 2021;47:631–636. doi:10.1007/s00068-020-01507-w
10. Dimaggio C, Ayoung-Chee P, Shinseki M, et al. Traumatic injury in the United States: In-patient epidemiology 2000-2011. Injury 2016;47:1393–403. doi:10.1016/j.injury.2016.04.002
11. Morris D, Rogers M, Kissmer N, et al. Impact of lockdown measures implemented during the Covid-19 pandemic on the burden of trauma presentations to a regional emergency department in Kwa-Zulu Natal, South Africa. African Journal of Emergency Medicine 2020;10:193–6. doi:10.1016/j.afjem.2020.06.005
12. Rhodes HX, Petersen K, Biswas S. Trauma Trends During the Initial Peak of the COVID-19 Pandemic in the Midst of Lockdown: Experiences From a Rural Trauma Center. Cureus 202;12(8): e9811. doi:10.7759/cureus.9811
13. Waseem S, Nayar SK, Hull P, et al. The global burden of trauma during the COVID-19 pandemic: A scoping review. Journal of Clinical Orthopaedics and Trauma 2021;12:200–7. doi:10.1016/j.jcot.2020.11.005
14. Waseem S, Romann R, Lenihan J. et al. Trauma epidemiology after easing of lockdown restrictions: experience from a level-one major trauma centre in England. Eur J Trauma Emerg Surg 2022;48:1471–1478 (2022). https://doi.org/10.1007/s00068-021-01725-w
15. Dolci A, Marongiu G, Leinardi L, et al. The Epidemiology of Fractures and Muskulo-Skeletal Traumas During COVID-19 Lockdown: A Detailed Survey of 17.591 Patients in a Wide Italian Metropolitan Area. Geriatr Orthop Surg Rehabil. 2020;11:2151459320972673. doi:10.1177/2151459320972673
16. Yasin YJ, Grivna M, Abu-Zidan FM. Global impact of COVID-19 pandemic on road traffic collisions. World J Emerg Surg 2021;16:51. https://doi.org/10.1186/s13017-021-00395-8
17. Coşkun S, Çinka H , Büyükceran İ, et al. An evaluation of orthopaedic trauma patients presenting at the emergency department during lockdown in the COVID-19 pandemic. J Health Sci Med / JHSM. 2022;5(1):79-83
18. Adiamah A, Thompson A, Lewis-Lloyd C, et al. The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK. Eur J Trauma Emerg Surg 2021;47:637–645 . https://doi.org/10.1007/s00068-020-01593-w