Comparing epidemiologic features, outcomes, and diagnostic and therapeutic procedures of traumatic patients before and during COVID-19 pandemic: Data from the National Trauma Registry of Iran / 中华创伤杂志(英文版)

PURPOSE@#To prepare for future possible communicable disease epidemics/pandemics, health care providers should know how the COVID-19 pandemic influenced injured patients. This study aimed to compare epidemiologic features, outcomes, and diagnostic and therapeutic procedures of trauma patients admitted to a university-affiliated hospital before and during the pandemic.@*METHODS@#This retrospective study was performed on data from the National Trauma Registry of Iran. All injured patients admitted to the hospital from July 25, 2016 to March 10, 2021 were included in the study. The patients were excluded if they had hospital length of stay less than 24 h. The injury outcomes, trauma mechanisms, and therapeutic and diagnostic procedures of the 2 periods: before (from July 25, 2016 to February 18, 2020) and during (from February 19, 2020 to March 10, 2021) COVID-19 pandemic were compared. All analyses were performed using STATA version 14.0 software (Stata Corporation, College Station, TX).@*RESULTS@#Totally, 5014 patients were included in the registry. Of them, 773 (15.4%) were registered after the beginning of the COVID-19 pandemic on February 19, 2020, while 4241 were registered before that. Gender, education level, and cause of injury were significantly different among the patients before and after the beginning of the pandemic (p < 0.001). In the ≤ 15 years and ≥ 65 years age groups, injuries decreased significantly during the COVID-19 pandemic (p < 0.001). The frequency of intensive care unit (ICU) admission decreased from 694 (16.4%) to 88 (11.4%) (p < 0.001). The mean length of stay at the hospital (days) and at the ICU (days) declined as follow: 8.3 (SD = 17.2) vs. 5.5 (SD = 6.1), p < 0.001 and 7.5 (SD = 11.5) vs. 4.5 (SD = 6.3), p < 0.022. The frequency of diagnostic and therapeutic procedures before and during the pandemic was as follows, respectively: ultrasonography 905 (21.3%) vs. 417 (53.9%) (p < 0.001), echocardiography 313 (7.4%) vs. 107 (13.8%) (p < 0.001), angiography 1597 (37.7%) vs. 534 (69.1%) (p < 0.001), MRI 166 (3.9%) vs. 51 (6.6%) (p < 0.001), surgery 3407 (80.3%) vs. 654 (84.6%) (p < 0.001), and internal/external fixation 1215 (28.6%) vs. 336 (43.5%) (p < 0.001).@*CONCLUSION@#The pandemic affected the epidemiology of traumatic patients in terms of gender, age, educational level, and trauma mechanism. It changed the outcomes of injured patients: ICU admission, length of stay at the hospital and ICU decreased. The patients received more diagnostic and therapeutic procedures during the pandemic. To be more precise, more research is needed on the details.

The Association of Food Insecurity with Type 2 Diabetes and Hypertension: A Multicenter Case-Control Study in Urban Population

@#Introduction: The household food insecurity (FI) is still one of global health issues, which is related to various health and developmental problems. The aim of this study was to evaluate the relationship of the FI with type 2 diabetes and hypertension in a city in North-West of Iran. Methods: Study population was the Khoy city’s households which refer to the primary health-care centers. The US Department of Agriculture (USDA) six-item Household Food Security Scale was used to determine food insecurity. Sample size for each case group (type 2 diabetic and hypertensive) was calculated to be 110 subjects and was doubled to be 220 subjects in the control group. Multi-stage random sampling method was applied. To control the confounding variables, the logistic regression was used. Results: In total, 210 subjects (47.7%) had food security and 52.3% were insecure. Seventeen percent of the study population had normal BMI (Body Mass Index) and 83% were obese or overweight (42.7% obese, 40.5% overweight). In multivariate analysis the age (p<0.001), BMI (p=0.002), and education (p=0.002) were significantly related to hypertension. However, food insecurity was not significantly related to diabetes and hypertension. Conclusion: High prevalence of FI, obesity and overweight in the population necessitate the educational interventions about healthy nutrition in families, especially from childhood. Financial and nutritional support is needed for the families with FI. Considering the indirect relationship between FI and hypertension shown in this study, it is recommended to implement interventions to reduce the FI as a risk factor of hypertension.