Effects of COVID-19 pandemic curfew on orthopedic trauma in a tertiary care hospital in Turkey

Abstract

Objective This study aimed to investigate whether various curfew practices affect trauma prevalence, epidemiological differences among the population admitted to hospital because of trauma, and treatment practices used after trauma. Methods Patients who suffered from fractures or soft-tissue trauma between March 21, 2020, and June 1, 2020, (group pandemic) and during the same period in 2019 (control group) were included in our single-center retrospective study. Each group was also divided into 3 subgroups according to the age of patients (≤ 20 years, 21–64 years, and ≥ 65 years). Data including anatomical region subjected to trauma, place of admission, mechanism of trauma, location of trauma, mode of treatment, type of surgery (if performed), duration of hospitalization (if hospitalized), time elapsed until surgery, and duration of postoperative hospitalization were collected and compared between groups. Results A total of 361 patients were admitted to the hospital with new trauma during the pandemic, and 708 patients had been admitted during the same period in 2019. The number of admissions decreased significantly by 50.9% ( P < 0.001). The mechanism of trauma that occurred with low energy was significantly increased in the pandemic group (73.9%) compared with the control group (47.6%) ( P < 0.001). Similarly, the distribution of trauma throughout the skeletal system, especially in the upper extremity, was significantly increased in the pandemic group (49.9% vs. 30.5%, P < 0.001). However, there was no significant decrease in individuals aged above 65 years ( P = 0.115). Similar to the general outlook, the 3 groups differed in terms of the mechanism of trauma, location of trauma, and distribution of the anatomical region subjected to trauma ( P < 0.001). Majority of the patients received inpatient treatment in all 3 groups ( P < 0.001). Conclusion The results of this study showed that the pandemic dramatically reduced the number of hospital admissions related to orthopedic trauma. The rate of low energy, upper extremity traumas that occurred indoors increased during the pandemic period compared with that of the previous year. However, the rate of hospital admissions did not differ in the ≥65-year-old subgroup during the pandemic period compared with that of the previous year. Level of Evidence Level III, Diagnostic Study

The Effect of the COVID-19 Pandemic on the Characteristics of Inpatients at the Orthopaedics and Traumatology Clinic in a Secondary Care Public Hospital in Turkey

“…With two research designs being most similar to ours, the study conducted by Kalem et al, investigating the effects of the COVID-19 pandemic curfew on orthopaedic trauma in our country, reported that the number of admissions due to trauma decreased by 50.9% during the pandemic, but the rate of trauma throughout the skeletal system, especially in the upper extremity, was reported to have increased from 30.5% to 49.9% [ 5 ]. The second study similar to ours, conducted by Turgut et al reported that, compared to the pre-pandemic period, the frequency of fractures decreased by about one-third during the pandemic, the average age of the patients with fractures in the paediatric group decreased, and finger fractures in paediatric patients and metatarsal fractures in adult patients decreased significantly during the pandemic [ 13 ].…”

“…Research has even shown that mortality rates increased due to myocardial infarction during the pandemic, notably because of refusal to present to the hospital [3,4]. Similar conditions appeared for both elective and emergency cases of orthopaedics and traumatology [5].…”

Change in orthopedics and traumatology admissions during the COVID-19 pandemic at a university hospital in Turkey

“…Both in Turkey and in other countries, the number of patients who admitted to the hospital after March 2020 was lower than the corresponding periods of the previous year. In studies conducted in tertiary hospitals in Turkey, Kalem et al, found that trauma cases admitted to the orthopedics department of a hospital in Ankara decreased by 50% [7], while Turgut et al, showed that the number of fracture-related applications in Izmir decreased from 1634 to 645 [8]. Significant reductions in trauma cases have been reported during the COVID-19 pandemic in Italy [9], the Republic of Ireland [10], and India [11].…”

Changes in trends of orthopedic services due to the COVID-19 pandemic: A review

“…Kalem et al [ 30 ] studied the effect of COVID-19 pandemic on the prevalence and epidemiology in 361 orthopedic trauma patients in Turkey. The study examined the fractures distribution in three age categories (≤ 20 years, 21-64 years, and ≥ 65 years).…”