How did social isolation change trauma patterns? Comparative analysis of isolation and normal periods

Abstract

Objective: This study examines the impact of COVID-19 lockdown measures on the demographic profiles and injury mechanisms of trauma patients in the emergency department (ED), while accounting for seasonal variations. Methods: A retrospective cohort study compared a seven-month full isolation period (Dec 2020 – June 2021) with a non- isolation period (Dec 2021 – June 2022) at a tertiary university hospital. Data were obtained via ICD-10 codes, and categorical variables were analyzed using the Chi-Square test. Results: Analysis included 2,439 patients from the isolation period and 8,736 from the non-isolation period. During isolation, the 18–44 age group's share of trauma presentations decreased from 56.1% to 47.0%, while the 65+ age group increased from 9.0% to 14.6% (p < 0.001). No significant difference was found in gender distribution. The rate of falls rose from 27.1% to 37.8% (p < 0.001), and penetrating and sharp object injuries (PSOI) increased from 9.9% to 12.1% (p = 0.002). While minor traumas like sprains decreased, motor vehicle accidents showed no proportional change. Conclusion: Isolation measures shifted the trauma focus from young adults to the geriatric population and from outdoor activities to indoor incidents (falls and PSOI). These findings provide a critical reference for ED triage and resource management in future pandemic planning.

Keywords

• Emergency Department
• COVID-19
• Isolation
• Pandemic
• Trauma Mechanisms

Sosyal izolasyon travma paternlerini nasıl değiştirdi? İzolasyon ve normal dönemlerin karşılaştırmalı analizi

Abstract

Amaç: Bu çalışma, COVID-19 tam kapanma tedbirlerinin acil servise başvuran travma hastalarının demografik profilleri ve yaralanma mekanizmaları üzerindeki etkisini, mevsimsel varyasyonları dikkate alarak incelemektedir. Yöntem: Retrospektif, kohort bu çalışmada; üçüncü basamak bir üniversite hastanesindeki yedi aylık tam izolasyon dönemi (Aralık 2020 – Haziran 2021) ile kısıtlamasız bir dönem (Aralık 2021 – Haziran 2022) karşılaştırılmıştır. Veriler ICD-10 kodları aracılığıyla elde edilmiş ve kategorik değişkenler Ki-Kare testi kullanılarak analiz edilmiştir. Bulgular: Analizlere izolasyon döneminden 2.439, izolasyon olmayan dönemden ise 8.736 hasta dahil edilmiştir. İzolasyon sırasında, 18-44 yaş grubunun travma başvurularındaki payı %56,1'den %47,0'ye gerilerken, 65 yaş ve üzeri grubun oranı %9,0'dan %14,6'ya yükselmiştir (p < 0,001). Cinsiyet dağılımında anlamlı bir fark saptanmamıştır. Düşme oranı %27,1'den %37,8'e (p < 0,001), delici ve kesici alet yaralanmaları (DKAY) ise %9,9'dan %12,1'e (p = 0,002) yükselmiştir. Burkulma gibi minör travmalar azalırken, motorlu taşıt kazalarında oransal bir değişim görülmemiştir. Sonuç: İzolasyon tedbirleri, travma odağını genç erişkinlerden geriatrik popülasyona; dış mekan aktivitelerinden ise ev içi olaylara (düşmeler ve DKAY) kaydırmıştır. Bu bulgular, gelecekteki pandemi planlamalarında acil servis triyajı ve kaynak yönetimi için kritik bir referans sağlamaktadır.

Keywords

• : Acil Servis
• COVID-19
• İzolasyon
• Pandemi
• Travma Mekanizmaları

References

1. 1. Miniño AM, Heron MP, Smith BL. Deaths and death rates for the 10 leading causes of death in specified age groups: United States, preliminary 2004-Con. Natl Vital Stat Rep 2006;54:28-9.
2. 2. Brunett PH, Cameron PA. Trauma. In: Tintinalli JE, Stapczynski JS, Ma OJ, Cline DM, Cydulka RK, Meckler GD, editors. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York: McGraw-Hill; 2011. p. 1671-6.
3. 3. Arthur LK, Debra EH. Injury control. In: Tintinalli JE, Kelen GD, Stapczynski JS, editors. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York: McGraw-Hill; 2004. p. 1646.
4. 4. Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19). Clin Exp Pediatr 2020;63(4):119-24.
5. 5. Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, Meşe EA. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci 2020;50(SI-1):489-94.
6. 6. Çelik Ş, Yurtbay S, Tekin YK, Korkmaz İ, Çelik P. Covid-19 pandemisinin acil servis hasta başvuru sayısına etkileri. Van Tıp Dergisi 2022;29(3):303-8.
7. 7. Wong JSH, Cheung KMC. Impact of COVID-19 on orthopaedic and trauma service: an epidemiological study. J Bone Joint Surg Am 2020;102(14):e80.
8. 8. Boserup B, McKenney M, Elkbuli A. The impact of the COVID-19 pandemic on emergency department visits and patient safety in the United States. Am J Emerg Med 2020;38(9):1732-6.

9. 9. Jojczuk M, Pawlikowski J, Kamiński P, et al. Evaluating changes in trauma epidemiology during the COVID-19 lockdown: insights and implications for public health and disaster preparedness. Healthcare (Basel) 2023;11(17):2436.
10. 10. Chiba H, Lewis M, Benjamin ER, et al. Safer at home: the effect of the COVID-19 lockdown on epidemiology, resource utilization, and outcomes at a large urban trauma center. J Trauma Acute Care Surg 2021;90(4):708-13.
11. 11. 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(7):1414-8.
12. 12. Ghafil C, Matsushima K, Ding L, Henry R, Inaba K. Trends in trauma admissions during the COVID-19 pandemic in Los Angeles County, California. JAMA Netw Open 2021;4(2):e211320.
13. 13. 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 2020;12(8):e9811.
14. 14. Rosen B, Pelle AL, Lakhi NA. Impact of the COVID-19 pandemic on trauma service utilization at a New York City level I trauma center. Pragmat Obs Res 2022;13:93-103.
15. 15. Ohliger E, Umpierrez E, Buehler L, et al. Mental health of orthopaedic trauma patients during the 2020 COVID-19 pandemic. Int Orthop 2020;44(10):1921-5.
16. 16. İlhan B, Bozdereli Berikol G, Aydın H, Arslan Erduhan M, Doğan H. COVID-19 outbreak impact on emergency trauma visits and trauma surgery in a level 3 trauma center. Ir J Med Sci 2022;191(5):2319-24.
17. 17. Chodos M, Sarani B, Sparks A, et al. Impact of COVID-19 pandemic on injury prevalence and pattern in the Washington, DC metropolitan region: a multicenter study by the American College of Surgeons Committee on Trauma. Trauma Surg Acute Care Open 2021;6(1):e000659.
18. 18. Al Harthi R, Al Hinai M, Al Abri M, AlMaamari A, Stephen E, Al Qadhi H. The impact of the COVID-19 pandemic on the pattern of trauma presenting to a tertiary care trauma centre in Oman. Sultan Qaboos Univ Med J 2023;23(3):297-302.