Informing future policy for trauma prevention: The effect of the COVID-19 'National state of disaster lockdown' on the trauma burden of a tertiary trauma centre in the Western Cape of South Africa.
Informing future policy for trauma prevention: The effect of the COVID-19 'National state of disaster lockdown' on the trauma burden of a tertiary trauma centre in the Western Cape of South Africa.
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DOI：
10.1016/j.afjem.2021.06.002
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Lategan H
中科院分区：
文献类型：
--
作者：
Mahoney SH;Steyn E;Lategan H
减少创伤负担的战略不仅是全球优先事项，而且也是南非公共卫生的优先事项，因为创伤负担过大。确定可预防伤害的促成因素将有助于指导地方和国际一级的政策和预防战略。为应对SARS-nCOV-2（COVID-19），南非实施了全国限制性封锁，其中包括全面禁止非必要旅行和酒类销售。随着2020年3月至5月期间实施的最密集的限制措施，这一时期为评估社会限制对创伤负担可能产生的影响提供了前所未有的机会。于2019年3月至5月期间进行了回顾性图表审查，并与2020年同期的数据进行了比较。进行描述性分析，以了解封锁的人口统计学和创伤的原因介绍的影响。结果显示，在早期封锁期间，创伤下降了51.42%。然而，亚组分析显示，损伤率的机制和患者的人口统计学变化不大。这项研究显示，尽管在2020年实施封锁程序后，创伤病例的全因呈现有所减少，但伤害模式和故意与意外伤害的比例基本保持不变。这提示需要进一步研究和根本原因分析如何改善创伤预防策略。这将有助于在一个创伤负担有据可查的国家提高创伤预防政策的效力，因此迫切需要一项可执行的全国性减少伤害政策。
Strategies to reduce the burden of trauma are not only a global priority, but also a South African public health priority due to a disproportionately large trauma burden. Identification of the contributors to preventable injuries would assist in guiding policy and prevention strategies at a local and international level. In response to SARS-nCOV-2 (COVID19), a national restrictive lockdown was implemented in South Africa with, amongst other restrictions, a complete ban on non-essential travel and alcohol sales. With the most intensive restrictions implemented between March to May 2020, this period offers an unprecedented opportunity for the assessment of social restrictions on possible effects of trauma burdens. A retrospective chart review was conducted between March to May 2019 and compared to data from the same period in 2020. Descriptive analysis was undertaken to understand the influence of lockdown on demographics and injury causation in trauma presentations. The results showed a 51.42% decline in trauma during the early lockdown period. Sub-analyses however, revealed little change in the mechanism of injury ratios and the demographics of presenting patients. This study shows that although all cause presentation of trauma cases was reduced following the implementation of lockdown procedures in 2020, the injury patterns and ratios of intentional to accidental harm remained largely unchanged. This prompts the need for further research and root cause analysis into how trauma prevention strategies can be improved. This will assist with the improved efficacy of trauma prevention policies in a country with a well-documented trauma burden and thus a pressing need for an implementable and nationwide harm reduction policy.
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