Impact of lockdown during the COVID-19 pandemic on number of patients and patterns of injuries at a level I trauma center

Abstract

Summary Objective The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and its associated illness, coronavirus disease 2019 (COVID-19), has led to a global health crisis burdening frontline emergency departments, including orthopedic and trauma units. The aim of this study was to provide an overview of the impact of the lockdown secondary to the pandemic on patient numbers and pattern of injuries at the department of traumatology of the Medical University of Vienna. Methods This retrospective, descriptive study identified all patients admitted and enrolled onto the trauma registry at a level I trauma center, between 15 March 2020 and 30 April 2020 (lockdown) and compared them to those between 15 March 2019 and 30 April 2019 (baseline). Variables collected included patient age, sex, reason for hospital admission, place of injury, death, injury severity score (ISS), as well as American Society of Anaesthesiologists (ASA) score. Results A total of 10,938 patient visits to the trauma emergency department were analyzed, 8353 presentations during the baseline period and 2585 during lockdown. Only 1869 acutely injured and 716 follow-up patients presented during lockdown, compared to 6178 and 2175, respectively, during baseline. Throughout the COVID-19 lockdown there were significant reductions in both workplace and traffic accidents, sports injuries, number of hospitalized patients, and overall visits to the trauma emergency department; however, the number of major traumas and hip fractures remained similar. Furthermore, there was a significant increase in the frequency of injuries at home as well as hospital admissions due to attempted suicide. Conclusion Despite the reduction in total number of patients, trauma departments should continue to provide adequate service during lockdown considering that severe injuries showed no change. Conditions such as breakdown of social networks and limited access to mental health care and support might account for the significant rise in hospital admissions due to suicides. We recommend that more attention and effort should be made to prevent this excess of suicide deaths.

Orthopaedic, trauma surgery, and Covid-2019 pandemic: clinical panorama and future prospective in Europe

“…Nine studies reported the impact of lockdown during the Covid-19 pandemic on injuries at level I trauma centres in Europe [ 40 – 48 ]. Compared to the pre-Covid-19 era, there was a significant reduction between 12.2% and 69.75% of patients presenting to trauma departments [ 40 – 48 ].…”

“…Nine studies reported the impact of lockdown during the Covid-19 pandemic on injuries at level I trauma centres in Europe [ 40 – 48 ]. Compared to the pre-Covid-19 era, there was a significant reduction between 12.2% and 69.75% of patients presenting to trauma departments [ 40 – 48 ]. Three studies showed no significant reductions of major trauma, defined as an injury severity score (ISS) of greater than 15 [ 42 , 44 , 48 ].…”

“…Road Traffic Collisions (RTCs), in the 2020 baseline time, accounted for 12.0 to 31.2% of trauma call activations. Conversely, in the period 2019, RTCs represented 14.0 to 54.5% of trauma call activations [ 40 , 41 , 43 , 45 – 47 ]. The studies which reported data form European trauma registries during the year 2020 versus the pre-Covid-19 era are shown in Table 2 .…”

Mortality and Epidemiological Changes in Proximal Hip Fractures in the Course of a Pandemic

“…Nia et al [ 11 ] described a decrease in all patient admissions by almost 70% in 2020. Compared with other conditions, the incidence of hip fractures was less affected by the social lockdown in the COVID period.…”

The Impact of COVID-19 Lockdown on Injuries in Saudi Arabia: Results From a Level-I Trauma Center

“…A study conducted in Italy that investigated wrist and hand injuries found a significant reduction in traffic crashes during the lockdown period than in 2019 (10). Similarly, a decrease in trauma has been observed during the COVID-19 pandemic in Netherlands, New Zealand, Australia, South Africa, and Austria (11)(12)(13)(14)(15)(16).…”