The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study.
The effects of a UK lockdown on orthopaedic trauma admissions and surgical cases: A multicentre comparative study.
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DOI：
10.1302/2633-1462.15.bjo-2020-0028.r1
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发表时间：
2020-05
期刊：
影响因子：
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通讯作者：
Wembridge K
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文献类型：
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作者：
Hampton M;Clark M;Baxter I;Stevens R;Flatt E;Murray J;Wembridge K
目前COVID-19导致的全球大流行对英国的医疗服务造成重大负担。于二零二零年三月二十三日，英国政府颁布全国封城规定。这项多中心研究的目的是更好地了解封锁对受伤率、机制和类型的影响，以及对区域创伤服务的管理。数据收集从成人重大创伤中心，儿科重大创伤中心，地区综合医院，和区域手外伤单位。数据收集包括患者人口统计学资料、损伤机制、损伤类型和所需治疗。研究的时间段对应于英国封锁前的两周、封锁期间的两周以及2019年同样的两周。与2019年相比，事故和急诊（A&E）总就诊人数减少了55.7%（12，935对5，733），封锁期间创伤入院人数减少了53.7%（354对164）。需要入院的脆性骨折患者数量保持不变（2019年为32例患者，封锁期间为31例患者; p > 0.05）。道路交通碰撞（57.1%，n = 8）是封锁期间重大创伤入院的最常见原因。有一个显着增加，在DIY相关的手受伤，（26%（n = 13））锁定vs 8%（2019年n = 11，p = 0.006），导致神经损伤增加（12%（封锁期间n = 6）vs 2.5%（2019年n = 3，p = 0.015）和手部感染（封锁期间24%（n = 12）vs 2019年6.2%（n = 8），p = 0.002）。全国封锁大大减少了骨科创伤的入院人数。需要手术的脆性骨折的发生率没有改变。手术室应保持适当的供应，以确保这些患者可以作为手术优先事项进行管理。DIY相关的手部损伤有所增加，这导致需要干预的神经损伤增加。
The current global pandemic due to COVID-19 is generating significant burden on the health service in the UK. On 23 March 2020, the UK government issued requirements for a national lockdown. The aim of this multicentre study is to gain a greater understanding of the impact lockdown has had on the rates, mechanisms and types of injuries together with their management across a regional trauma service. Data was collected from an adult major trauma centre, paediatric major trauma centre, district general hospital, and a regional hand trauma unit. Data collection included patient demographics, injury mechanism, injury type and treatment required. Time periods studied corresponded with the two weeks leading up to lockdown in the UK, two weeks during lockdown, and the same two-week period in 2019. There was a 55.7% (12,935 vs 5,733) reduction in total accident and emergency (A&E) attendances with a 53.7% (354 vs 164) reduction in trauma admissions during lockdown compared to 2019. The number of patients with fragility fractures requiring admission remained constant (32 patients in 2019 vs 31 patients during lockdown; p > 0.05). Road traffic collisions (57.1%, n = 8) were the commonest cause of major trauma admissions during lockdown. There was a significant increase in DIY related-hand injuries (26% (n = 13)) lockdown vs 8% (n = 11 in 2019, p = 0.006) during lockdown, which resulted in an increase in nerve injuries (12% (n = 6 in lockdown) vs 2.5% (n = 3 in 2019, p = 0.015) and hand infections (24% (n = 12) in lockdown vs 6.2% (n = 8) in 2019, p = 0.002). The national lockdown has dramatically reduced orthopaedic trauma admissions. The incidence of fragility fractures requiring surgery has not changed. Appropriate provision in theatres should remain in place to ensure these patients can be managed as a surgical priority. DIY-related hand injuries have increased which has led to an increased in nerve injuries requiring intervention.