COVID-19:全国由准备就绪的创伤系统护理的穿透性创伤增加

IF 1.4 Q3 SURGERY Surgery open science Pub Date : 2024-07-03 DOI:10.1016/j.sopen.2024.06.007
Mallory Jebbia, Jeffry Nahmias, Matthew Dolich, Sebastian Schubl, Michael Lekawa, Lourdes Swentek, Areg Grigorian
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引用次数: 0

摘要

背景COVID-19 大流行对美国人的集体心理产生了负面影响。包括社会隔离在内的社会经济困难导致枪支销售增加。先前的地区性研究表明,大流行期间穿透性创伤增加,但目前尚不清楚创伤系统是否为穿透性创伤的涌入做好了准备。本研究旨在证实全国穿透性创伤增加的趋势,并假设与大流行前相比,在大流行期间接受治疗的穿透性创伤患者有更高的并发症和死亡风险。方法将 2017-2020 年创伤质量改进计划数据库分为大流行前(2017-2019 年)和大流行年(2020 年)。结果在3525132名患者中,有936890人(26.6%)在大流行期间就诊。与大流行前的病人相比,大流行期间病人的刀伤率(4.8% 对 4.5%,P> 0.001)和枪伤率(5.8% 对 4.6%,P< 0.001)较高。在穿透性创伤患者中,大流行前和大流行期间的住院并发症发生率和相关风险(5.0 % vs. 5.1 %,p = 0.38)(OR 0.98,CI 0.94-1.02,p = 0.26)相似,但在大流行期间,调整后的死亡风险下降(8.结论这项全国性分析证实,在 COVID-19 大流行期间,穿透性创伤的发生率有所上升,枪伤的发生率更高。然而,这并没有导致死亡或并发症风险的增加,这表明全国各地的创伤系统已经做好了应对 COVID 和枪支暴力双重流行的准备。
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COVID-19: A national rise in penetrating trauma cared for by a prepared trauma system

Background

The COVID-19 pandemic negatively impacted the collective American psyche. Socioeconomic hardships including social isolation led to an increase in firearm sales. Previous regional studies demonstrated increased penetrating trauma during the pandemic but it is unclear if trauma systems were prepared for this influx of penetrating injuries. This study aimed to confirm this increased penetrating trauma trend nationally and hypothesized penetrating trauma patients treated during the pandemic had a higher risk of complications and death, compared to pre-pandemic patients.

Methods

The 2017–2020 Trauma Quality Improvement Program database was divided into pre-pandemic (2017–2019) and pandemic years (2020). Bivariate analyses and a multivariable logistic regression analyses were performed controlling for age, comorbidities, injuries, and vitals on arrival.

Results

From 3,525,132 patients, 936,890 (26.6 %) presented during the pandemic. The pandemic patients had a higher rate of stab-wounds (4.8 % vs. 4.5 %, p > 0.001) and gunshot wounds (5.8 % vs. 4.6 %, p < 0.001) compared to pre-pandemic patients. Among penetrating trauma patients, the rate and associated risk of in-hospital complications (5.0 % vs. 5.1 %, p = 0.38) (OR 0.98, CI 0.94–1.02, p = 0.26) was similar between pre-pandemic and pandemic cohorts but adjusted risk of mortality decreased during the pandemic (8.3 % vs. 8.3 %, p = 0.45) (OR 0.92, CI 0.89–0.96, p < 0.001).

Conclusion

This national analysis confirms an increased rate of penetrating trauma during the COVID-19 pandemic, with a higher rate of gunshot injuries. However, this did not result in an increased risk of death or complications suggesting that trauma systems across the country were prepared to handle a dual pandemic of COVID and firearm violence.

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CiteScore
1.30
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0.00%
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审稿时长
66 days
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