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The Trends in Volume of Trauma-Related Visits to Emergency Department During the COVID-19 Pandemic

Yıl 2021, Cilt 11, Sayı 5, 673 - 678, 17.09.2021

Öz

Aim: After the first case in Wuhan, China in late 2019, COVID-19 quickly spread and affected the whole world. While it had been recommended to postpone healthcare services for non-emergency cases, several studies showed that many emergency cases were decreased as well. In this study, we aimed to investigate whether the trends in visits to the emergency department (ED) were altered during the COVID period. Materials: We evaluated the ED visits between July 1, 2019 and June 30, 2020 due to transport injuries, falls, interpersonal violence and self-harm using International Classification of Diseases, 10th revision codes. Pre-COVID period was defined as July 2019-Mar 2020 and COVID period was defined as April-June 2020. To show whether there was a significant change between pre-COVID and COVID periods (monthly), we used piecewise regression analyses. Results: In total, there were 14,958 ED visits due to transport injuries, falls, interpersonal violence and self-harm during the study period. Piecewise regression analysis revealed that ED visits for transport injury (p=0.028), falls (p=0.006) and interpersonal violence (p=0.007) significantly decreased, whereas, there was a significant increase in visits for self-harm (p<0.001) in COVID period, when compared with pre-COVID period. Conclusion: This is the first study showing that the number of ED visits for transport injury, falls and interpersonal violence were decreased and those for self-harm were increased during the COVID-19 pandemic. A maximum effort should be made by authorities to understand the reason behind these trends, particularly for self-harm behaviors.

Kaynakça

  • [1] WHO. Coronavirus disease (COVID-19): Situation Report-209. 2020.
  • [2] CDC. Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html; 2020. [accessed 03.09.2020.
  • [3] Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE, III, Hoppe JA, et al. Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US. JAMA Internal Medicine. 2020https://doi.org/10.1001/jamainternmed.2020.3288.
  • [4] Mafham MM, Spata E, Goldacre R, Gair D, Curnow P, Bray M, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. The Lancet. 2020;396(10248):381-9. https://doi.org/10.1016/S0140-6736(20)31356-8.
  • [5] Kundi H, Balci MM, Gungorer B, Yesiltepe M, Coskun N, Surel AA. Trends in acute myocardial infarction admissions during the COVID-19 pandemic in Ankara, Turkey. Anatol J Cardiol. 2020;24(2):81-2. https://doi.org/10.14744/AnatolJCardiol.2020.70206.
  • [6] Rodriguez-Leor O, Cid-Álvarez B, Ojeda S, Martín-Moreiras J, Rumoroso JR, López-Palop R, et al. Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC Interv Cardiol. 2020;2:82-9.
  • [7] Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. J Am Coll Cardiol. 2020;75(22):2871-2. https://doi.org/10.1016/j.jacc.2020.04.011.
  • [8] Sutherland M, McKenney M, Elkbuli A. Vehicle related injury patterns during the COVID-19 pandemic: What has changed? The American Journal of Emergency Medicine. 2020;38(9):1710-4. https://doi.org/10.1016/j.ajem.2020.06.006.
  • [9] Way TL, Tarrant SM, Balogh ZJ. Social restrictions during COVID-19 and major trauma volume at a level 1 trauma centre. Medical journal of Australia. https://doi.org/10.5694/mja2.50843
  • [10] Balogh ZJ, Way TL, Hoswell, RL. The epidemiology of trauma during a pandemic. Injury, 51(6), 1243-1244. https://doi.org/10.1016/j.injury.2020.05.039.
  • [11] von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International journal of surgery (London, England). 12.12 (2014): 1495-9. https://doi.org/10.1016/j.ijsu.2014.07.013
  • [12] Republic of Turkey Ministry of Health, Health Statistics Yearbook 2018. 2020.
  • [13] Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990&#x2013;2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2015;386(9995):743-800. https://doi.org/10.1016/S0140-6736(15)60692-4.
  • [14] Demirbilek Y, Pehlivantürk G, Özgüler Z, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci. 2020;50(Si-1):489-94. https://doi.org/10.3906/sag-2004-187.
  • [15] Bayar G. Normalization in Turkey starts after virus restrictions, https://www.aa.com.tr/en/latest-on-coronavirus-outbreak/normalization-in-turkey-starts-after-virus-restrictions/1860901; 2020. [accessed 02.09.2020.
  • [16] Kundi H, Birinci S, Surel AA, Ulgu MM, Balci MM, Coskun N, et al. Trends in acute myocardial infarction volume and related outcomes during the coronavirus disease 2019 pandemic in Turkey. Coronary artery disease. (2021). https://doi.org/10.1097/MCA.0000000000001023
  • [17] Kundi H, Cohen DJ, Strom JB, Valsdottir L, Shen C, Choi E, et al. Trends in isolated aortic valve replacement in the United States in the early phase of expansion of TAVR. International journal of cardiology. 292 (2019): 68-72. https://doi.org/10.1016/j.ijcard.2019.06.061
  • [18] Kostis WJ, Deng Y, Pantazopoulos JS, Moreyra AE, Kostis JB, Myocardial Infarction Data Acquisition System (MIDAS14) Study Group. Trends in mortality of acute myocardial infarction after discharge from the hospital. Circulation. Cardiovascular quality and outcomes. 3.6 (2010): 581-9. https://doi.org/10.1161/CIRCOUTCOMES.110.957803
  • [19] Hakkert AS, Braimaister L, Van Schagen I. The uses of exposure and risk in road safety studies. SWOV Institute for Road Safety; 2002.
  • [20] Badr HS, Du H, Marshall M, Dong E, Squire MM, Gardner LM. Association between mobility patterns and COVID-19 transmission in the USA: a mathematical modelling study. The Lancet Infectious Diseases. 2020 https://doi.org/10.1016/s1473-3099(20)30553-3.
  • [21] Choi NG, Choi BY, DiNitto DM, Marti CN, Kunik ME. Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics. BMC Geriatrics. 2019;19(1):303. https://doi.org/10.1186/s12877-019-1329-2.
  • [22] Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American journal of public health. 1992;82(7):1020-3. https://doi.org/10.2105/ajph.82.7.1020.
  • [23] Bergen G, Stevens MR, Burns ER. Falls and Fall Injuries Among Adults Aged >/=65 Years - United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(37):993-8. https://doi.org/10.15585/mmwr.mm6537a2.
  • [24] Women U. Issue Brief: COVID-19 and Ending Violence Against Women and Girls. 2020.
  • [25] Cheung YT, Chau PH, Yip PS. A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong. Int J Geriatr Psychiatry. 2008;23(12):1231-8. https://doi.org/10.1002/gps.2056.
  • [26] Ayers JW, Leas EC, Johnson DC, Poliak A, Althouse BM, Dredze M, et al. Internet Searches for Acute Anxiety During the Early Stages of the COVID-19 Pandemic. JAMA Intern Med. 2020 https://doi.org/10.1001/jamainternmed.2020.3305.
  • [27] Oglesby ME, Capron DW, Raines AM, Schmidt NB. Anxiety sensitivity cognitive concerns predict suicide risk. Psychiatry Research. 2015;226(1):252-6. https://doi.org/10.1016/j.psychres.2014.12.057.
  • [28] Yokota M, Fujita T, Nakahara S, Sakamoto T. Clarifying differences in injury patterns between ground-level falls and falls from heights among the elderly in Japan. Public health, 2020;181, 114-118. doi: 10.1016/j.puhe.2019.11.020
  • [29] Birdsey M, Islam MR, Barmare A. Sporting injuries, seasonal trend and impact on rural Australian hospitals: Implications and recommendations. The Australian journal of rural health, 2016;24(6), 402-408. doi: 10.1111/ajr.12278
  • [30] Trousdale WH, Abdel MP, Viste A, Trousdale RT, Callaghan JJ, Berry DJ. Seasonality of Periprosthetic Femur Fractures in 12,700 Primary and Revision Total Hip Arthroplasties. The Journal of arthroplasty, 2020;32(6), 2000-2004. doi: 10.1016/j.arth.2017.02.049

COVID-19 Salgını Sırasında Travmaya Bağlı Acil Servis Başvurularındaki Değişimler

Yıl 2021, Cilt 11, Sayı 5, 673 - 678, 17.09.2021

Öz

Amaç: 2019'un sonlarında Çin'in Wuhan kentinde yaşanan ilk vakanın ardından COVID-19 hızla yayıldı ve tüm dünyayı etkiledi. Acil olmayan vakalar için sağlık hizmetlerinin ertelenmesi önerilmiş olsa da, birkaç çalışmada birçok acil vakanın da azaldığı gösterilmiştir. Bu çalışmada, travma kaynaklı acil servis başvurularının COVID-19 pandemisi sırasındaki değişimini araştırmayı amaçladık. Yöntem: ICD-10 kodları kullanılarak 1 Temmuz 2019 - 30 Haziran 2020 tarihleri arasında trafik kazası, düşme, darp ve özkıyım nedeniyle acil servis başvuran hastalar belirlendi. COVID öncesi dönem Temmuz 2019-Mart 2020, COVID dönemi ise Nisan-Haziran 2020 olarak tanımlandı. COVID öncesi ve COVID dönemleri arasındaki değişimin değerlendirilmesi için parçalı regresyon analizleri kullanıldı. Bulgular: Çalışma döneminde trafik kazası, düşme, darp ve özkıyım nedeniyle toplam 14.958 acil servis başvurusu yapılmıştı. COVID döneminde, COVID öncesi döneme kıyasla trafik kazası (p = 0,028), düşme (p = 0,006) ve darp (p = 0,007) sebebiyle yapılan acil servis başvurularında anlamlı azalma, özkıyım sebebiyle yapılan başvurularda ise anlamlı artma olduğu görüldü (p<0,001). Sonuç: COVID-19 salgını sırasında trafik kazası, düşme ve darp nedeniyle yapılan acil servis başvurularının azaldığı, özkıyım nedeniyle yapılan başvuruların ise arttığı görülmektedir. Başvuru sıklıklarındaki bu değişimlerin arkasındaki nedenlerin anlaşılması için azami çaba gösterilmelidir.

Kaynakça

  • [1] WHO. Coronavirus disease (COVID-19): Situation Report-209. 2020.
  • [2] CDC. Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html; 2020. [accessed 03.09.2020.
  • [3] Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE, III, Hoppe JA, et al. Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US. JAMA Internal Medicine. 2020https://doi.org/10.1001/jamainternmed.2020.3288.
  • [4] Mafham MM, Spata E, Goldacre R, Gair D, Curnow P, Bray M, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. The Lancet. 2020;396(10248):381-9. https://doi.org/10.1016/S0140-6736(20)31356-8.
  • [5] Kundi H, Balci MM, Gungorer B, Yesiltepe M, Coskun N, Surel AA. Trends in acute myocardial infarction admissions during the COVID-19 pandemic in Ankara, Turkey. Anatol J Cardiol. 2020;24(2):81-2. https://doi.org/10.14744/AnatolJCardiol.2020.70206.
  • [6] Rodriguez-Leor O, Cid-Álvarez B, Ojeda S, Martín-Moreiras J, Rumoroso JR, López-Palop R, et al. Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC Interv Cardiol. 2020;2:82-9.
  • [7] Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. J Am Coll Cardiol. 2020;75(22):2871-2. https://doi.org/10.1016/j.jacc.2020.04.011.
  • [8] Sutherland M, McKenney M, Elkbuli A. Vehicle related injury patterns during the COVID-19 pandemic: What has changed? The American Journal of Emergency Medicine. 2020;38(9):1710-4. https://doi.org/10.1016/j.ajem.2020.06.006.
  • [9] Way TL, Tarrant SM, Balogh ZJ. Social restrictions during COVID-19 and major trauma volume at a level 1 trauma centre. Medical journal of Australia. https://doi.org/10.5694/mja2.50843
  • [10] Balogh ZJ, Way TL, Hoswell, RL. The epidemiology of trauma during a pandemic. Injury, 51(6), 1243-1244. https://doi.org/10.1016/j.injury.2020.05.039.
  • [11] von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International journal of surgery (London, England). 12.12 (2014): 1495-9. https://doi.org/10.1016/j.ijsu.2014.07.013
  • [12] Republic of Turkey Ministry of Health, Health Statistics Yearbook 2018. 2020.
  • [13] Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990&#x2013;2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2015;386(9995):743-800. https://doi.org/10.1016/S0140-6736(15)60692-4.
  • [14] Demirbilek Y, Pehlivantürk G, Özgüler Z, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci. 2020;50(Si-1):489-94. https://doi.org/10.3906/sag-2004-187.
  • [15] Bayar G. Normalization in Turkey starts after virus restrictions, https://www.aa.com.tr/en/latest-on-coronavirus-outbreak/normalization-in-turkey-starts-after-virus-restrictions/1860901; 2020. [accessed 02.09.2020.
  • [16] Kundi H, Birinci S, Surel AA, Ulgu MM, Balci MM, Coskun N, et al. Trends in acute myocardial infarction volume and related outcomes during the coronavirus disease 2019 pandemic in Turkey. Coronary artery disease. (2021). https://doi.org/10.1097/MCA.0000000000001023
  • [17] Kundi H, Cohen DJ, Strom JB, Valsdottir L, Shen C, Choi E, et al. Trends in isolated aortic valve replacement in the United States in the early phase of expansion of TAVR. International journal of cardiology. 292 (2019): 68-72. https://doi.org/10.1016/j.ijcard.2019.06.061
  • [18] Kostis WJ, Deng Y, Pantazopoulos JS, Moreyra AE, Kostis JB, Myocardial Infarction Data Acquisition System (MIDAS14) Study Group. Trends in mortality of acute myocardial infarction after discharge from the hospital. Circulation. Cardiovascular quality and outcomes. 3.6 (2010): 581-9. https://doi.org/10.1161/CIRCOUTCOMES.110.957803
  • [19] Hakkert AS, Braimaister L, Van Schagen I. The uses of exposure and risk in road safety studies. SWOV Institute for Road Safety; 2002.
  • [20] Badr HS, Du H, Marshall M, Dong E, Squire MM, Gardner LM. Association between mobility patterns and COVID-19 transmission in the USA: a mathematical modelling study. The Lancet Infectious Diseases. 2020 https://doi.org/10.1016/s1473-3099(20)30553-3.
  • [21] Choi NG, Choi BY, DiNitto DM, Marti CN, Kunik ME. Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics. BMC Geriatrics. 2019;19(1):303. https://doi.org/10.1186/s12877-019-1329-2.
  • [22] Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American journal of public health. 1992;82(7):1020-3. https://doi.org/10.2105/ajph.82.7.1020.
  • [23] Bergen G, Stevens MR, Burns ER. Falls and Fall Injuries Among Adults Aged >/=65 Years - United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(37):993-8. https://doi.org/10.15585/mmwr.mm6537a2.
  • [24] Women U. Issue Brief: COVID-19 and Ending Violence Against Women and Girls. 2020.
  • [25] Cheung YT, Chau PH, Yip PS. A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong. Int J Geriatr Psychiatry. 2008;23(12):1231-8. https://doi.org/10.1002/gps.2056.
  • [26] Ayers JW, Leas EC, Johnson DC, Poliak A, Althouse BM, Dredze M, et al. Internet Searches for Acute Anxiety During the Early Stages of the COVID-19 Pandemic. JAMA Intern Med. 2020 https://doi.org/10.1001/jamainternmed.2020.3305.
  • [27] Oglesby ME, Capron DW, Raines AM, Schmidt NB. Anxiety sensitivity cognitive concerns predict suicide risk. Psychiatry Research. 2015;226(1):252-6. https://doi.org/10.1016/j.psychres.2014.12.057.
  • [28] Yokota M, Fujita T, Nakahara S, Sakamoto T. Clarifying differences in injury patterns between ground-level falls and falls from heights among the elderly in Japan. Public health, 2020;181, 114-118. doi: 10.1016/j.puhe.2019.11.020
  • [29] Birdsey M, Islam MR, Barmare A. Sporting injuries, seasonal trend and impact on rural Australian hospitals: Implications and recommendations. The Australian journal of rural health, 2016;24(6), 402-408. doi: 10.1111/ajr.12278
  • [30] Trousdale WH, Abdel MP, Viste A, Trousdale RT, Callaghan JJ, Berry DJ. Seasonality of Periprosthetic Femur Fractures in 12,700 Primary and Revision Total Hip Arthroplasties. The Journal of arthroplasty, 2020;32(6), 2000-2004. doi: 10.1016/j.arth.2017.02.049

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Bülent GÜNGÖRER (Sorumlu Yazar)
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ACİL TIP ANABİLİM DALI
0000-0002-9856-7181
Türkiye


Metin YEŞİLTEPE
ANKARA ŞEHİR HASTANESİ, DİJİTAL HASTANE VE ANALİTİK YÖNETİM BİRİMİ
0000-0002-0456-3332
Türkiye


Nazım COŞKUN
ANKARA ŞEHİR HASTANESİ, DİJİTAL HASTANE VE ANALİTİK YÖNETİM BİRİMİ
0000-0002-1458-9392
Türkiye


Gulhan KURTOGLU CELİK
YILDIRIM BEYAZIT ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ACİL TIP ANABİLİM DALI
0000-0003-1259-3694
Türkiye

Yayımlanma Tarihi 17 Eylül 2021
Kabul Tarihi 13 Haziran 2021
Yayınlandığı Sayı Yıl 2021, Cilt 11, Sayı 5

Kaynak Göster

AMA Güngörer B. , Yeşiltepe M. , Coşkun N. , Kurtoglu Celik G. The Trends in Volume of Trauma-Related Visits to Emergency Department During the COVID-19 Pandemic. J Contemp Med. 2021; 11(5): 673-678.