How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdown
Introduction: On June 24 in the United Kingdom, there were 277,989 cases of COVID-19 and 39,369 deaths recorded. The government enforced a complete lockdown on March 23 that resulted in cessation of all elective admissions on 24th onward, with only acute trauma cases being admitted to hospital. This...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Emergencies, Trauma and Shock |
| Subjects: | |
| Online Access: | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2021;volume=14;issue=2;spage=75;epage=79;aulast=Dass |
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| author | Debashis Dass Eamon Ramhamadany Siddarth Govilkar John-Henry Rhind David Ford Rohit Singh Geraint Thomas Paul Cool |
| author_facet | Debashis Dass Eamon Ramhamadany Siddarth Govilkar John-Henry Rhind David Ford Rohit Singh Geraint Thomas Paul Cool |
| author_sort | Debashis Dass |
| collection | DOAJ |
| description | Introduction: On June 24 in the United Kingdom, there were 277,989 cases of COVID-19 and 39,369 deaths recorded. The government enforced a complete lockdown on March 23 that resulted in cessation of all elective admissions on 24th onward, with only acute trauma cases being admitted to hospital. This study aims to characterize the changes in trauma admissions during the first 5-week lockdown period. The hypothesis states that there would be a significant reduction in overall orthopedic trauma admissions, polytrauma, and high-energy outdoor trauma during this COVID-19 period. Methods: All trauma admissions over nearly a 5-week period from March 23, 2020, to April 26, 2020, were collated as the “COVID cohort” and compared to the “control” group of patients from the same hospitals 1 year before between March 23, 2019, and April 26, 2019. Spinal admissions and pediatrics were excluded from the study as they were managed in other regional units. Results: There was a 56% reduction in trauma admissions during the COVID-19 lockdown (133 vs. 304). A majority of the COVID cohort were admitted with fractures (89 vs. 164, P = 0.017, Chi-square test) from home with low-energy falls. Overall, fewer operations were performed than the year before. However, a greater proportion of admitted patients had a surgical orthopedic intervention rather than admission and nonoperative management. Conclusions: There was a reduction in admissions as well as reductions in high energy and occupational injuries. Elderly patients continued to fall at home or in care, sustaining hip fractures. This vulnerable group requires beds, orthogeriatric management followed by surgical intervention and social care. Orthogeriatric services must be maintained to ensure the best clinical outcomes for this group. |
| first_indexed | 2024-12-17T05:55:25Z |
| format | Article |
| id | doaj.art-de24a88bfaa443b48a32228ce43a84f2 |
| institution | Directory Open Access Journal |
| issn | 0974-2700 |
| language | English |
| last_indexed | 2024-12-17T05:55:25Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Emergencies, Trauma and Shock |
| spelling | doaj.art-de24a88bfaa443b48a32228ce43a84f22022-12-21T22:01:04ZengWolters Kluwer Medknow PublicationsJournal of Emergencies, Trauma and Shock0974-27002021-01-01142757910.4103/JETS.JETS_137_20How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdownDebashis DassEamon RamhamadanySiddarth GovilkarJohn-Henry RhindDavid FordRohit SinghGeraint ThomasPaul CoolIntroduction: On June 24 in the United Kingdom, there were 277,989 cases of COVID-19 and 39,369 deaths recorded. The government enforced a complete lockdown on March 23 that resulted in cessation of all elective admissions on 24th onward, with only acute trauma cases being admitted to hospital. This study aims to characterize the changes in trauma admissions during the first 5-week lockdown period. The hypothesis states that there would be a significant reduction in overall orthopedic trauma admissions, polytrauma, and high-energy outdoor trauma during this COVID-19 period. Methods: All trauma admissions over nearly a 5-week period from March 23, 2020, to April 26, 2020, were collated as the “COVID cohort” and compared to the “control” group of patients from the same hospitals 1 year before between March 23, 2019, and April 26, 2019. Spinal admissions and pediatrics were excluded from the study as they were managed in other regional units. Results: There was a 56% reduction in trauma admissions during the COVID-19 lockdown (133 vs. 304). A majority of the COVID cohort were admitted with fractures (89 vs. 164, P = 0.017, Chi-square test) from home with low-energy falls. Overall, fewer operations were performed than the year before. However, a greater proportion of admitted patients had a surgical orthopedic intervention rather than admission and nonoperative management. Conclusions: There was a reduction in admissions as well as reductions in high energy and occupational injuries. Elderly patients continued to fall at home or in care, sustaining hip fractures. This vulnerable group requires beds, orthogeriatric management followed by surgical intervention and social care. Orthogeriatric services must be maintained to ensure the best clinical outcomes for this group.http://www.onlinejets.org/article.asp?issn=0974-2700;year=2021;volume=14;issue=2;spage=75;epage=79;aulast=Dasscovid-19pandemicreconfigurationtraumatrauma and orthopedics |
| spellingShingle | Debashis Dass Eamon Ramhamadany Siddarth Govilkar John-Henry Rhind David Ford Rohit Singh Geraint Thomas Paul Cool How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdown Journal of Emergencies, Trauma and Shock covid-19 pandemic reconfiguration trauma trauma and orthopedics |
| title | How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdown |
| title_full | How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdown |
| title_fullStr | How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdown |
| title_full_unstemmed | How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdown |
| title_short | How a pandemic changes trauma: epidemiology and management of trauma admissions in the UK during COVID-19 lockdown |
| title_sort | how a pandemic changes trauma epidemiology and management of trauma admissions in the uk during covid 19 lockdown |
| topic | covid-19 pandemic reconfiguration trauma trauma and orthopedics |
| url | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2021;volume=14;issue=2;spage=75;epage=79;aulast=Dass |
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