Impact of the COVID-19 shutdown on orthopedic trauma numbers and patterns in an academic Level I Trauma Center in Berlin, Germany.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 20 08 2020
accepted: 28 01 2021
entrez: 16 2 2021
pubmed: 17 2 2021
medline: 27 2 2021
Statut: epublish

Résumé

The COVID-19 pandemic led to the implementation of drastic shutdown measures worldwide. While quarantine, self-isolation and shutdown laws helped to effectively contain and control the spread of SARS-CoV-2, the impact of COVID-19 shutdowns on trauma care in emergency departments (EDs) remains elusive. All ED patient records from the 35-day COVID-19 shutdown (SHUTDOWN) period were retrospectively compared to a calendar-matched control period in 2019 (CTRL) as well as to a pre (PRE)- and post (POST)-shutdown period in an academic Level I Trauma Center in Berlin, Germany. Total patient and orthopedic trauma cases and contacts as well as trauma causes and injury patterns were evaluated during respective periods regarding absolute numbers, incidence rate ratios (IRRs) and risk ratios (RRs). Daily total patient cases (SHUTDOWN vs. CTRL, 106.94 vs. 167.54) and orthopedic trauma cases (SHUTDOWN vs. CTRL, 30.91 vs. 52.06) decreased during the SHUTDOWN compared to the CTRL period with IRRs of 0.64 and 0.59. While absolute numbers decreased for most trauma causes during the SHUTDOWN period, we observed increased incidence proportions of household injuries and bicycle accidents with RRs of 1.31 and 1.68 respectively. An RR of 2.41 was observed for injuries due to domestic violence. We further recorded increased incidence proportions of acute and regular substance abuse during the SHUTDOWN period with RRs of 1.63 and 3.22, respectively. While we observed a relevant decrease in total patient cases, relative proportions of specific trauma causes and injury patterns increased during the COVID-19 shutdown in Berlin, Germany. As government programs offered prompt financial aid during the pandemic to individuals and businesses, additional social support may be considered for vulnerable domestic environments.

Sections du résumé

BACKGROUND
The COVID-19 pandemic led to the implementation of drastic shutdown measures worldwide. While quarantine, self-isolation and shutdown laws helped to effectively contain and control the spread of SARS-CoV-2, the impact of COVID-19 shutdowns on trauma care in emergency departments (EDs) remains elusive.
METHODS
All ED patient records from the 35-day COVID-19 shutdown (SHUTDOWN) period were retrospectively compared to a calendar-matched control period in 2019 (CTRL) as well as to a pre (PRE)- and post (POST)-shutdown period in an academic Level I Trauma Center in Berlin, Germany. Total patient and orthopedic trauma cases and contacts as well as trauma causes and injury patterns were evaluated during respective periods regarding absolute numbers, incidence rate ratios (IRRs) and risk ratios (RRs).
FINDINGS
Daily total patient cases (SHUTDOWN vs. CTRL, 106.94 vs. 167.54) and orthopedic trauma cases (SHUTDOWN vs. CTRL, 30.91 vs. 52.06) decreased during the SHUTDOWN compared to the CTRL period with IRRs of 0.64 and 0.59. While absolute numbers decreased for most trauma causes during the SHUTDOWN period, we observed increased incidence proportions of household injuries and bicycle accidents with RRs of 1.31 and 1.68 respectively. An RR of 2.41 was observed for injuries due to domestic violence. We further recorded increased incidence proportions of acute and regular substance abuse during the SHUTDOWN period with RRs of 1.63 and 3.22, respectively.
CONCLUSIONS
While we observed a relevant decrease in total patient cases, relative proportions of specific trauma causes and injury patterns increased during the COVID-19 shutdown in Berlin, Germany. As government programs offered prompt financial aid during the pandemic to individuals and businesses, additional social support may be considered for vulnerable domestic environments.

Identifiants

pubmed: 33592046
doi: 10.1371/journal.pone.0246956
pii: PONE-D-20-26095
pmc: PMC7886210
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0246956

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Tazio Maleitzke (T)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.
Julius Wolff Institute, Charité -Universitätsmedizin Berlin, Berlin, Germany.
Berlin Institute of Health (BIH), Berlin, Germany.

Matthias Pumberger (M)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Undine A Gerlach (UA)

Division of Emergency and Acute Medicine, Campus Charité Mitte and Virchow-Klinikum, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Carolin Herrmann (C)

Institute of Biometry and Clinical Epidemiology, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Anna Slagman (A)

Division of Emergency and Acute Medicine, Campus Charité Mitte and Virchow-Klinikum, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Louise S Henriksen (LS)

Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Frederic von Mauchenheim (F)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Nils Hüttermann (N)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Anabel N Santos (AN)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Florian N Fleckenstein (FN)

Berlin Institute of Health (BIH), Berlin, Germany.
Department of Diagnostic and Interventional Radiology, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Geraldine Rauch (G)

Institute of Biometry and Clinical Epidemiology, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Sven Märdian (S)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Carsten Perka (C)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Ulrich Stöckle (U)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Martin Möckel (M)

Division of Emergency and Acute Medicine, Campus Charité Mitte and Virchow-Klinikum, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Tobias Lindner (T)

Division of Emergency and Acute Medicine, Campus Charité Mitte and Virchow-Klinikum, Charité -Universitätsmedizin Berlin, Berlin, Germany.

Tobias Winkler (T)

Center for Musculoskeletal Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany.
Julius Wolff Institute, Charité -Universitätsmedizin Berlin, Berlin, Germany.
Berlin Institute of Health (BIH), Berlin, Germany.
Berlin Institute of Health Center for Regenerative Therapies, Charité -Universitätsmedizin Berlin, Berlin, Germany.

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