Impact of the Lockdown due to COVID-19 Pandemic on the Spectrum and Outcome of Trauma in India

Hazra, Darpanarayan; Jindal, Anmol; Fernandes, Joanna Preritha

doi:10.5005/jp-journals-10071-23758

Cited by 12 publications

(15 citation statements)

References 11 publications

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“…2. Only 4 studies out of 35 reported a positive percentage increase compared to the pre‐restriction period [19–22] (see Figure A1 in the Appendix for a breakdown at the continent level).…”

Section: Resultsmentioning

confidence: 99%

“…These studies were included in the descriptive figures and in the demographic table. The remaining seven studies reported a low/moderate risk of bias [19, 21, 23, 34, 40, 48, 49]. With further informal screening to assess the comparability of outcomes and potential biases in the population included, these were included in the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

“…2. Only 4 studies out of 35 reported a positive percentage increase compared to the pre-restriction period [19][20][21][22] (see Figure A1 in the Appendix for a breakdown at the continent level). Key clinical characteristics of the hospitalised cases are summarised in Table 2.…”

Section: Major Trauma Admissions and Clinical Characteristics Of Pati...mentioning

confidence: 99%

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The Epidemiology of Major Trauma During the First Wave of COVID‐19 Movement Restriction Policies: A Systematic Review and Meta‐analysis of Observational Studies

et al. 2022

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Background The objective of this systematic review is to investigate changes in the epidemiology of major trauma presentations during the implementation of movement restriction measures to manage the first wave of the SARS-CoV-2 (COVID-19) pandemic. Methods A systematic search in six databases, as well as a search of grey literature was performed from January 2020 to August 2021. Estimates were pooled using random-effects meta-analysis. The certainty of evidence was rated according to the GRADE approach. The review is reported using both PRISMA guideline and the MOOSE checklist. Results In total, 35 studies involving 36,987 patients were included. The number of major trauma admissions overall decreased during social movement restrictions (−24%; p < 0.01; 95% CI [−0.31; −0.17]). A pooled analysis reported no evidence of a change in the severity of trauma admissions (OR:1.17; 95%CI [0.77, 1.79], I2 = 77%). There was no evidence for a change in mortality during the COVID-19 period (OR:0.94, 95%CI [0.80,1.11], I2 = 53%). There was a statistically significant reduction in motor vehicle trauma (OR:0.70; 95%CI [0.61, 0.81], I2 = 91%) and a statistically significant increase in admissions due to firearms and gunshot wounds (OR:1.34; 95%CI [1.11, 1.61], I2 = 73%) and suicide attempts and self-harm (OR:1.41; 95%CI [1.05, 1.89], I2 = 39%). Conclusions and relevance Although evidence continues to emerge, this systematic review reports some decrease in absolute major trauma volume with unchanged severity and mortality during the first wave of COVID-19 movement restriction policies. Current evidence does not support the reallocation of highly specialised trauma professionals and trauma resources. Registration PROSPERO ID CRD42020224827.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Epidemiology of Major Trauma During the First Wave of COVID‐19 Movement Restriction Policies: A Systematic Review and Meta‐analysis of Observational Studies

et al. 2022

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“…Results of presentations with falls to the ED are diverse reporting higher [12] or lower numbers during the pandemic period [13][14][15][16]. In our study, we showed that the number of geriatric fall presentations to ED, comorbidity burden, consultations, and LOS at the ED in those patients was lower, but direct costs were higher in the pandemic period than pre-pandemic period.…”

Section: Discussionmentioning

confidence: 59%

Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods

Arslan

Saraç

Ersel

et al. 2023

Preprint

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Purpose This study aimed to investigate the clinical characteristics, presentations, outcomes, and healthcare costs of older patients who presented at the emergency department (ED) with falls in the periods before and during the Coronavirus disease-2019 (COVID-19) pandemic.Methods Hospital records one year before and after the onset of the COVID-19 pandemic were retrospectively analyzed through “International Statistical Classification of Diseases-10th Revision” codes. Age, gender, falls, triage classification, length of stay (LOS) in the hospital and ED, COVID-19 status, Glasgow coma scale (GCS), consultations-comorbidities, injury status, outcomes in the ED, and costs were recorded.Results The study comprised of 3,187 patients aged ≥ 65 years admitted to the ED of a university hospital between March 2019 and 2021. In terms of pre-pandemic and pandemic periods; older patients presenting with falls to the ED, consultations, Charlson Comorbidity Index (CCI), and LOS in ED were lower in the pandemic period, but costs were higher (p = 0.03, p = 0.01, p = 0.01, p = 0.01 and p = 0.02, respectively). Hospitalization/mortality rates were higher in COVID-19-positive patients (77.2%) than in COVID-19-negative patients (4.6%) within the pandemic period and the patients in the pre-pandemic period (22.8%), likewise for the costs (both p = 0.01).Conclusion Though the number of geriatric fall presentations to ED, comorbidity burden, consultations, and LOS in the ED was lower, direct costs were higher during the pandemic period, particularly for COVID-19 positive older patients admitted to ED with falls than the pre-pandemic period, and those patients were with poorer outcomes.

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“…The current Corona Virus Disease 19 (COVID-19) pandemic lockdown restriction imposed in most countries have resulted in a significant reduction in trauma victims with a positive blood alcohol content which perhaps is the silver lining of the ongoing pandemic. [ 25 - 27 ]…”

Section: Discussionmentioning

confidence: 99%

A Retrospective analysis of the profile of trauma victims presenting to an emergency department in South India

Kundavaram

Jindal

Hazra

et al. 2022

Journal of Family Medicine and Primary Care

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Background: Trauma is a leading cause of morbidity and mortality in both developed and developing countries. Methodology: This retrospective observational study was done in the Emergency Department (ED) of a tertiary care trauma center in Southern India in 2018 (January to December). Results: During the study period of 1 year, the ED attended 74,466 patients which included 7675 (10.3%) trauma patients. The mean age was 35.3 (SD: 18.5) years with three-fourth (76.6%) being males. Pediatric/adolescents (age ≤18 years) and geriatric age groups (age ≥60 years) comprised 16.7% and 11.8% cases, respectively. Road traffic accidents (RTA) (66%) were the predominant mode of injury followed by falls (fall from height: 8.6% and fall on level ground: 7.8%). Among the RTAs, the majority were two-wheelers related (73.8%), followed by pedestrian injuries (9.4%) and four-wheelers injuries (7.2%). Bivariate and multivariate logistic regression analysis showed pedestrian injuries, low Glasgow Coma Scale (GCS), and hypotension at arrival as independent predictors of hospital mortality. The in-hospital mortality rate was 0.7%. A quarter (24%; n = 1841) of the patient’s population was solely managed by the ED team and discharged stable, while 2179 (28.4%) victims required hospital admission. Conclusion: Trauma is a major cause of mortality especially among the breadwinners of families in India with almost half being due to two-wheeler accidents. Efficient ED professionals and a multispecialty team of trauma surgeons, neurosurgeons, and orthopedics handle the major load of acute trauma. Pedestrian injuries, low GCS, and hypotension at arrival are independent predictors of in-hospital mortality.

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Impact of the Lockdown due to COVID-19 Pandemic on the Spectrum and Outcome of Trauma in India

Cited by 12 publications

References 11 publications

The Epidemiology of Major Trauma During the First Wave of COVID‐19 Movement Restriction Policies: A Systematic Review and Meta‐analysis of Observational Studies

The Epidemiology of Major Trauma During the First Wave of COVID‐19 Movement Restriction Policies: A Systematic Review and Meta‐analysis of Observational Studies

Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods

A Retrospective analysis of the profile of trauma victims presenting to an emergency department in South India

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