ABSTRACT
AIMS: Coronavirus disease 2019 (COVID-19) resulted in the implementation of public health restrictions to reduce transmission. These restrictions have reduced trauma-related admissions to hospitals. Auckland, New Zealand, had two periods of Level 4 lockdowns, in 2020 and 2021. In the 2021 lockdown, Aucklanders were generally less compliant with the restrictions. Therefore, we hypothesised that trauma-related activity would be greater in the 2021 lockdown compared to 2020. METHODS: A retrospective descriptive study of trauma admissions to Auckland City Hospital (ACH) during 2020 (26 March to 27 April 2020-33 days) and 2021 (18 August to 21 September 2021-35 days) lockdown periods was performed. RESULTS: Trauma admissions and trauma call activations increased from 97 to 105 (8.2%) and from 35 to 46, respectively, in the 2021 lockdown compared to 2020. The numbers of males and road related injuries requiring admission were increased from 49 to 66 (p = 0.077) and from 21 to 28 (p = 0.439), respectively, in 2021 compared to 2020. Major trauma admissions increased from 13 to 23 in the 2021 lockdown compared to 2020. CONCLUSIONS: Trauma-related presentations to hospital were higher in the 2021 Auckland lockdown compared to 2020. Lockdown fatigue and reduced compliance in 2021 may have contributed to this finding, suggesting that future lockdowns may be less effective.
Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Hospitalization , Humans , Male , New Zealand/epidemiology , Retrospective StudiesABSTRACT
AIMS: Coronavirus disease 2019 (COVID-19) resulted in the implementation of public health restrictions to reduce transmission. These restrictions have reduced trauma-related admissions to hospitals. Auckland, New Zealand, had two periods of Level 4 lockdowns, in 2020 and 2021. In the 2021 lockdown, Aucklanders were generally less compliant with the restrictions. Therefore, we hypothesised that trauma-related activity would be greater in the 2021 lockdown compared to 2020. METHODS: A retrospective descriptive study of trauma admissions to Auckland City Hospital (ACH) during 2020 (26 March to 27 April 2020-33 days) and 2021 (18 August to 21 September 2021-35 days) lockdown periods was performed. RESULTS: Trauma admissions and trauma call activations increased from 97 to 105 (8.2%) and from 35 to 46, respectively, in the 2021 lockdown compared to 2020. The numbers of males and road related injuries requiring admission were increased from 49 to 66 (p = 0.08) and from 21 to 28 (p = 0.44), respectively, in 2021 compared to 2020. Major trauma admissions increased from 13 to 23 in the 2021 lockdown compared to 2020. CONCLUSIONS: Trauma-related presentations to hospital were higher in the 2021 Auckland lockdown compared to 2020. Lockdown fatigue and reduced compliance in 2021 may have contributed to this finding, suggesting that future lockdowns may be less effective.
ABSTRACT
Being one of the most common causes of the acute abdomen, acute appendicitis (AA) forms the bread and butter of any general surgeon's practice. With the recent advancements in AA's management, much controversy in diagnostic algorithms, possible differential diagnoses, and weighing the management options has been generated, with no absolute consensus in the literature. Since Alvarado described his eponymous clinical scoring system in 1986 to stratify AA risk, there has been a burgeoning of additional scores for guiding downstream management and mortality assessment. Furthermore, advancing literature on the role of antibiotics, variations in appendicectomy, and its adjuncts have expanded the surgeon's repertoire of management options. Owing to the varied presentation, diagnostic tools, and management of AA have also been proposed in special groups such as pregnant patients, the elderly, and the immunocompromised. This article seeks to raise the critical debates about what is currently known about the above aspects of AA and explore the latest controversies in the field. Considering the ever-evolving coronavirus disease 2019 situation worldwide, we also discuss the pandemic's repercussions on patients and how surgeons' practices have evolved in the context of AA.