Adding to the story, did penetrating trauma really increase? changes in trauma patterns during the COVID-19 pandemic: A multi-institutional, multi-region investigation.
Adding to the story, did penetrating trauma really increase? changes in trauma patterns during the COVID-19 pandemic: A multi-institutional, multi-region investigation.
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DOI：
10.1016/j.injury.2022.02.034
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发表时间：
2022-06
期刊：
影响因子：
2.5
通讯作者：
Saillant NN
中科院分区：
文献类型：
--
作者：
Mokhtari AK;Maurer LR;Dezube M;Langeveld K;Wong YM;Hardman C;Hafiz S;Sharrah M;Soe-Lin H;Chapple KM;Peralta R;Rattan R;Butler C;Parks JJ;Mendoza AE;Velmahos GC;Saillant NN
单地区研究的结果表明，在2019冠状病毒病（COVID-19）暴发的最初几个月，居家令（SAHOs）对创伤性损伤的数量和模式产生了不可预见的影响。本研究的目的是使用多区域方法描述COVID-19 saho对美国创伤量和创伤损伤模式的影响。一项回顾性队列研究在横跨美国三个地理区域的四个经过验证的一级创伤中心进行。研究期间为2020年4月1日至2020年7月31日，包括一个与2019年一个月匹配的队列。患者被分为COVID-19前期（PCOV19）和首次COVID-19激增（FCOV19S）队列。通过创伤登记处查询收集患者人口统计、损伤和结局数据。进行单因素和多因素分析。在PCOV19（2,916）和fcov19（2,700）研究期间，共有5,616名患者进入参与研究中心。由于机动车碰撞（MVCs）次数的显著减少（p = 0.003），钝性损伤体积减少（p = 0.006）。穿透性创伤的发生率显著增加，从2019年的8%（246/2916）增加到2020年的11% (285/ 2700)(p = 0.007)，这与研究地点（p = 0.002）有关，而与saho无关。最后，研究地点与几乎所有损伤机制的变化显著相关，而SAHOs导致钝性损伤计算周平均值的下降（p < 0.02）和MVCs （p = 0.003）。本研究结果表明，COVID-19和初始SAHOs对创伤性损伤的模式有不同的影响，并且在初始SAHOs期间，创伤性损伤的区域特异性变化随之而来。这些结果表明，其他因素，可能是社会经济或文化因素，混淆了由saho引起的创伤的数量和类型。未来的分析必须考虑区域变化如何被汇总的队列所掩盖，并将重点放在描述社区层面的变化上，以帮助市政当局为未来类似事件做好准备。
Results from single-region studies suggest that stay at home orders (SAHOs) had unforeseen consequences on the volume and patterns of traumatic injury during the initial months of the Coronavirus disease 2019 (COVID-19). The aim of this study was to describe, using a multi-regional approach, the effects of COVID-19 SAHOs on trauma volume and patterns of traumatic injury in the US. A retrospective cohort study was performed at four verified Level I trauma centers spanning three geographical regions across the United States (US). The study period spanned from April 1, 2020 – July 31, 2020 including a month-matched 2019 cohort. Patients were categorized into pre-COVID-19 (PCOV19) and first COVID-19 surge (FCOV19S) cohorts. Patient demographic, injury, and outcome data were collected via Trauma Registry queries. Univariate and multivariate analyses were performed. A total 5,616 patients presented to participating study centers during the PCOV19 (2,916) and FCOV19S (2,700) study periods. Blunt injury volume decreased (p = 0.006) due to a significant reduction in the number of motor vehicle collisions (MVCs) (p = 0.003). Penetrating trauma experienced a significant increase, 8% (246/2916) in 2019 to 11% (285/2,700) in 2020 (p = 0.007), which was associated with study site (p = 0.002), not SAHOs. Finally, study site was significantly associated with changes in nearly all injury mechanisms, whereas SAHOs accounted for observed decreases in calculated weekly averages of blunt injuries (p < 0.02) and MVCs (p = 0.003). Results of this study suggest that COVID-19 and initial SAHOs had variable consequences on patterns of traumatic injury, and that region-specific shifts in traumatic injury ensued during initial SAHOs. These results suggest that other factors, potentially socioeconomic or cultural, confound trauma volumes and types arising from SAHOs. Future analyses must consider how regional changes may be obscured with pooled cohorts, and focus on characterizing community-level changes to aid municipal preparation for future similar events.
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