Alcohol and cannabis use in traffic-related injuries in Mexico City.

BACTERKGROUND: There is debate on whether cannabis affects road traffic injuries (RTIs) separately from the effects of alcohol. Our goals are to report the possible increase in risk of an RTI among alcohol and cannabis users by type of exposure (biological, self-reported and combined) and the possible interaction of alcohol and cannabis in patients with an RTI in an emergency department in Mexico City. METHODS: A case-crossover study with 433 cases of RTI (as a pedestrian, driver or passenger) during the period January-April 2022. A breath sample, an oral sample for cannabis detection and self-reported alcohol and cannabis use 6 hours prior to the RTI and in two control periods were used. We report ORs and 95% CIs from conditional logistic regressions for the case-crossover estimates. RESULTS: Alcohol alone increased the risk of an RTI (OR=6.02, 95% CI 3.29 to 10.99) for most RTIs, regardless of whether we used information from self-reports or a breath sample in the hazard period. Conversely, cannabis only increased the RTI when we added information in the hazard period from self-reports or oral samples. Nevertheless, this increase in risk disappeared (OR=2.06, 95% CI 0.90 to 4.70) among those who only used cannabis. We also found no evidence of interaction between alcohol and cannabis in the risk of an RTI. CONCLUSIONS: Alcohol is the most commonly used substance in Mexico and a high-risk factor for RTI in Mexico City. Although cannabis alone was not associated with an RTI, continuous monitoring of its effects is required.

Sofa and bed-related pediatric trauma injuries treated in United States emergency departments.

INTRODUCTION: Children under the age of 5 years suffer from the highest rates of fall-related injuries. Caretakers often leave young children on sofas and beds, however, falling and rolling off these fixtures can lead to serious injury. We investigated the epidemiologic characteristics and trends of bed and sofa-related injuries among children aged <5 years treated in US emergency departments (EDs). METHODS: We conducted a retrospective analysis of data from the National Electronic Injury Surveillance System from 2007 through 2021 using sample weights to estimate national numbers and rates of bed and sofa-related injuries. Descriptive statistics and regression analyses were employed. RESULTS: An estimated 3,414,007 children aged <5 years were treated for bed and sofa-related injuries in emergency departments (EDs) in the United States from 2007 through 2021, averaging 115.2 injuries per 10,000 persons annually. Closed head injuries (30%) and lacerations (24%) comprised the majority of injuries. The primary location of injury was the head (71%) and upper extremity (17%). Children <1 year of age accounted for most injuries, with a 67% increase in incidence within the age group between 2007 and 2021 (p < 0.001). Falling, jumping, and rolling off beds and sofas were the primary mechanisms of injury. The proportion of jumping injuries increased with age. Approximately 4% of all injuries required hospitalization. Children <1 year of age were 1.58 times more likely to be hospitalized after injury than all other age groups (p < 0.001). CONCLUSION: Beds and sofas can be associated with injury among young children, especially infants. The annual rate of bed and sofa-related injuries among infants <1 year old is increasing, which underscores the need for increased prevention efforts, including parental education and improved safety design, to decrease these injuries.

Hospitalization for child maltreatment and other types of injury during the COVID-19 pandemic.

BACKGROUND: The possibility that child maltreatment was misclassified as unintentional injury during the COVID-19 pandemic has not been evaluated. OBJECTIVE: We assessed if child maltreatment hospitalizations changed during the pandemic, and if the change was accompanied by an increase in unintentional injuries. PARTICIPANTS AND SETTING: This study included children aged 0-4 years who were admitted for maltreatment or unintentional injuries between April 2006 and March 2021 in hospitals of Quebec, Canada. METHODS: We used interrupted time series regression to estimate the effect of the pandemic on hospitalization rates for maltreatment, compared with unintentional transport accidents, falls, and mechanical force injuries. We assessed if the change in maltreatment hospitalization was accompanied by an increase in specific types of unintentional injury. RESULTS: Hospitalizations for child maltreatment decreased from 16.3 per 100,000 (95 % CI 9.1-23.4) the year before the pandemic to 13.2 per 100,000 (95 % CI 6.7-19.7) during the first lockdown. Hospitalizations for most types of unintentional injury also decreased, but injuries due to falls involving another person increased from 9.0 to 16.5 per 100,000. Hospitalization rates for maltreatment and unintentional injury remained low during the second lockdown, but mechanical force injuries involving another person increased from 3.8 to 8.1 per 100,000. CONCLUSIONS: Hospitalizations for child maltreatment may have been misclassified as unintentional injuries involving another person during the pandemic. Children admitted for these types of unintentional injuries may benefit from closer assessment to rule out maltreatment.

Pediatric all-terrain vehicle (ATV) related head injury rates and patterns: A 10-year nationwide analysis.

INTRODUCTION: The use of all-terrain vehicles (ATVs) carries significant risk of permanent injury and death, disproportionately affecting children. These injuries commonly affect the head and are especially severe among children as they are often unhelmeted and more likely than adults to experience rollover injuries. Many studies examining patients with ATV-related injuries are single-center cohort studies, with few focusing specifically on head injuries. In the present study, we aimed to characterize the annual incidence of ATV-related head injuries between 2012 and 2021, classify and compare head injury types, and identify descriptive characteristics of ATV-related head injury victims. METHODS: Using the US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) database, we queried all head injuries associated with operating or riding an ATV in children under 18 years-old from over 100 emergency departments (EDs). Patient information regarding age, race, sex, location of incident, diagnoses, and sequelae were analyzed. We also collected the estimated number of ATV-related head injuries from all US EDs using the NEISS algorithm provided by the database. RESULTS: Using the NEISS algorithm we identified 67,957 (95% CI: 43,608 - 92,305) total pediatric ATV-related head injuries between 2012 and 2021. The annual incidence of ATV-related head injury was similar throughout this study period except for a 20% increase during the COVID-19 pandemic period of 2019-2021 (2019: 6382 injuries, 2020: 6757 injuries, 2021: 7600 injuries). A subset of 1890 cases from approximately 100 EDs were then analyzed. Unspecified closed head injuries were the prevailing type of injury (38%, 900/1890), followed by concussions (27%, 510/1890). More severe injuries included intracranial hemorrhages in 91 children (3.8%, 91/1890). Injuries of all types were predominantly seen in 14-17 year-old's (780/1890, 41%) and in males (64.1%, 1211/1890). In addition, ATV-associated injuries were significantly more common in those coded as white (58.0%, 1096/1890) than any other racial group. ATV-associated accidents among children younger than 9 more commonly occurred at the home compared to accidents involving children older than 9 (57% vs. 32%, p < 0.0001). CONCLUSION: ATV-related head injuries cause a significant annual burden among children, with growing incidence in recent years. Further research may wish to explore potential benefits of helmet use and supervision of younger children in possible prevention of these accidents and their associated economic and non-economic costs.

Drug and Alcohol Use in Trauma Patients Before and During the COVID-19 Pandemic.

INTRODUCTION: Since the implementation of national stay-at-home orders during the COVID-19 pandemic, there has been rising concerns regarding prolonged social isolation that many individuals face. Given the link between increased stress and alcohol and drug use, our study investigated admission trends and patterns of alcohol and drug use in trauma patients. METHODS: This was a single center, retrospective cohort study comparing trauma patients admitted before the pandemic and during the first wave. We compared patient demographics, injury characteristics, and outcomes of substance screen negative, positive, and unscreened patients admitted. Patients screened positive if they had a positive urine drug screen (UDS) and/or a blood alcohol concentration (BAC) ≥10 mg/dL. RESULTS: There were 3906 trauma admissions in the year prior to and 3469 patients in the first year of the pandemic. No significant demographic differences were presented across time periods. Rates of UDS and BAC screening remained consistent. Equivalent rates of alcohol and drug positivity occurred (34% versus 33%, 17% versus 18%, P = 0.49). The total prevalence of alcohol use disorders (4% versus 5%, P < 0.001) and psychiatric disorders (6% versus 7%, P = 0.02) increased during the pandemic. CONCLUSIONS: The prevalence of diagnosed alcohol use and psychiatric disorders in trauma patients increased during the COVID-19 pandemic while rates of acute alcohol and drug screen positivity remained the same. These observations suggest a possible link between pandemic stressors and exacerbation of alcohol use and psychiatric conditions in trauma patients. During a changing pandemic landscape, it remains pertinent to increased screening for these conditions regardless of substance screen positivity upon admission.

Impact of COVID-19 on U.S. Hospital-Based Injury Prevention Professionals: A National Survey.

BACKGROUND: COVID-19 challenged U.S. trauma centers to grapple with demands for expanded services with finite resources while also experiencing a concurrent increase in violent injuries. OBJECTIVE: The purpose of this study was to describe the impact of COVID-19 on the roles and duties of U.S. hospital-based injury prevention professionals. METHODS: This descriptive cross-sectional survey study of hospital-based injury prevention professionals was conducted between June 2021 and August 2021. Participants were recruited from six organizational members of the national Trauma Prevention Coalition, including the American Trauma Society, Emergency Nurses Association, Injury Free Coalition for Kids, Safe States Alliance, Society for Trauma Nurses, and Trauma Center Association of America. Results were analyzed using descriptive and inferential statistics. RESULTS: A total of 216 participants affiliated with 227 trauma centers responded. The following changes were reported during 2020: change in injury prevention position (range = 31%-88%); change in duties (range = 92%-100%); and change to hospital-based injury prevention programs (range = 75%-100%). Sixty-one (43%) single-center participants with a registered nurse license were reassigned to clinical duties compared with six (10%) nonlicensed participants (OR = 5.6; 95% CI [1.96, 13.57]; p < .001). Injury prevention programs at adult-only and combined adult and pediatric trauma centers had higher odds of suspension than pediatric-only trauma centers (OR = 3.6; 95% CI [1.26, 10.65]; p < .017). CONCLUSION: The COVID-19 response exposed the persistent inequity and limited prioritization of injury prevention programming as a key deliverable for trauma centers.

[Features of unintentional injury in children under the impact of coronavirus disease 2019]. / æ–°åž‹å† çŠ¶ç— æ¯’è‚ºç‚Žç–«æƒ ä¸‹å„¿ç«¥æ„å¤–ä¼¤å®³çš„ç‰¹å¾.

OBJECTIVES: To study the features of unintentional injury in children under the impact of coronavirus disease 2019 (COVID-19). METHODS: A retrospective analysis was performed on the medical data of 2 526 children with unintentional injury in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2019 to June 2022. The study period was divided into 5 stages: before the epidemic (July to December, 2019), the Wuhan epidemic period (January to April, 2020), the epidemic remission period in China (May 2020 to February 2022), the Shanghai epidemic period (March to May, 2022), and the epidemic remission period in Shanghai (June 2022). The incidences of unintentional injury in children at different time stages and different ages were compared. A questionnaire survey was conducted on 107 children of the 2 526 children to explore the features of unintentional injury. RESULTS: There were significant differences in gender composition, age, age distribution and proportion of many types of unintentional injuries among the five time stages (P<0.05). There was a reduction in the number of children who attended the emergency department due to unintentional injury during the Wuhan epidemic and the Shanghai epidemic. The proportion of children with trauma-related unintentional injuries in each stage reached more than 50%, and the proportion of children with trauma-related unintentional injuries reached 63.9% and 82.0%, respectively during the Wuhan epidemic and the Shanghai epidemic. Most children suffering from unintentional injury were mainly school-aged and preschool children (1 823 children, 72.17%). Compared with the same period of Shanghai epidemic in 2021, the age of children with unintentional injury was younger (median 7 years vs 11 years), and the proportion of children with trauma-related unintentional injuries increased (97% vs 69%) during the Shanghai epidemic (P<0.05). CONCLUSIONS: Under the COVID-19 epidemic, there is a reduction in the number of children with unintentional injury, while there is an increase in the proportion of children with trauma-related unintentional injuries. Unintentional injury is more common among school-aged and preschool children.

Outcomes improvement despite continuous visits of severely injured patients during the COVID-19 outbreak: experience at a regional trauma centre in South Korea.

BACKGROUND: Understanding the changes in characteristics of patients who visited trauma centres during the coronavirus disease 2019 (COVID-19) pandemic is important to facilitate aneffective response. This retrospective study was conducted to analyse differences in the characteristics and outcomes of patients who visited our trauma centre between pre-COVID-19 and COVID-19 eras. METHODS: Medical data of trauma patients enrolled in the Korean trauma database from 1 January 2018 to 31 August 2021 were collected. The number of trauma centre visits, patient characteristics, factors associated with in-hospital intervention, and outcomes werecompared between patients in the two time periods. Propensity score matching was performed to analyse the outcomes in patients with similar characteristics and severitybetween patients in the two time periods. RESULTS: The number of emergency department (ED) trauma service visits reduced in the COVID-19 era. Based on the mean age, the patients were older in the COVID-19 era. Abbreviated injury scale (AIS) 1, AIS3, AIS5, and injury severity score (ISS) were higher in the COVID-19 era. The proportion of motor vehicle collisions decreased, whereas falls increased during the COVID-19 era. Ambulance transportation, admission to the general ward, and time from injury to ED visit significantly increased. Patient outcomes, such as hospital length of stay (LOS), intensive care unit (ICU) LOS, and duration of mechanical ventilation improved, while injury severity worsened during the COVID-19 era. After adjusting for patient characteristics and severity, similar findings were observed. CONCLUSION: The small reduction in the number of trauma patients and visits by patients who hadhigher ISS during the COVID-19 pandemic highlights the importance of maintaining trauma service capacity and capability during the pandemic. A nationwide or nationalmulticentre study will be more meaningful to examine the impact of the COVID-19 outbreak on the changes in trauma patterns, volume, and patient outcomes.

Pediatric Injury Transfer Patterns During the COVID-19 Pandemic: An Interrupted time Series Analysis.

INTRODUCTION: With the expected surge of adult patients with COVID-19, the Children's Hospital Association recommended a tiered approach to divert children to pediatric centers. Our objective was understanding changes in interfacility transfer to Pediatric Trauma Centers (PTCs) during the first 6 mo of the pandemic. METHODS: Children aged < 18 y injured between January 1, 2016 and September 30, 2020, who met National Trauma Databank inclusion criteria from 9 PTCs were included. An interrupted time-series analysis was used to estimate an expected number of transferred patients compared to observed volume. The "COVID" cohort was compared to a historical cohort (historical average [HA]), using an average across 2016-2019. Site-based differences in transfer volume, demographics, injury characteristics, and hospital-based outcomes were compared between cohorts. RESULTS: Twenty seven thousand thirty one/47,382 injured patients (57.05%) were transferred to a participating PTC during the study period. Of the COVID cohort, 65.4% (4620/7067) were transferred, compared to 55.7% (3281/5888) of the HA (P < 0.001). There was a decrease in 15-y-old to 17-y-old patients (10.43% COVID versus 12.64% HA, P = 0.003). More patients in the COVID cohort had injury severity scores ≤ 15 (93.25% COVID versus 87.63% HA, P < 0.001). More patients were discharged home after transfer (31.80% COVID versus 21.83% HA, P < 0.001). CONCLUSIONS: Transferred trauma patients to Level I PTC increased during the COVID-19 pandemic. The proportion of transferred patients discharged from emergency departments increased. Pediatric trauma transfers may be a surrogate for referring emergency department capacity and resources and a measure of pediatric trauma triage capability.

How many acute orthopaedic injuries are preventable?

PURPOSE: Injury prevention is important. Injury as a result of an accident carries with it huge cost to the individual and society including health services costs. Understanding the mechanism of injury is important to identify those injuries that are preventable. The aim of this study was to assess how many acute orthopaedic injuries were preventable should reasonable human interventions have been taken METHODS: This prospective study was performed in a UK district general hospital that serves a population of 500,000 people. All patients referred to the Orthopaedic department over 4 weeks between 16th November and 14th December 2020 were reviewed. Data was collected about the mechanism of injury, patient demographics, injury type, injury location, treatment and length of stay in hospital. The mechanisms of injury were analysed thematically. RESULTS: We assessed 605 patient attendances. 502 patients sustained 516 acute traumatic injuries. Preventable injuries were common, accounting for 23.9% of all referrals. The upper limb was most commonly injured with the hand and forearm being injured 33% of the time. Of the preventable injuries 35% were treated operatively. Thematic analysis identified common mechanisms of: occupational related, stairs, RTA, cycling, alcohol related, trampoline, DIY and assault. CONCLUSION: This study identifies that a large proportion of acute orthopaedic injuries are potentially preventable meaning this is an important area for further study. Occupation injuries were identified as an area in which there is the greatest scope to reduce the number of preventable accidents.

The COVID-19 pandemic reduced the trauma incidence and modified its pattern in Al-Ain City, United Arab Emirates.

AIM: We aimed to study the impact of the COVID-19 pandemic on the pattern of injury and outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates, to use this information in the preparedness for future pandemics. METHODS: We retrospectively compared the trauma registry data of all hospitalised trauma patients, who were treated at the two main trauma centres in Al-Ain City (Al-Ain Hospital and Tawam Hospital); those who were treated over 1 year before the pandemic (n = 2002) and those who were treated at the first year of the COVID-19 pandemic (n = 1468). RESULTS: There was a 26.7% reduction in the overall incidence of trauma admissions in the COVID-19 pandemic period. The mechanism of injury significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase in the number of injuries, due to machinery and falling objects during the pandemic (39.7% and 54.1% respectively, p < 0.001). In contrast, road traffic collisions and falls were reduced by 33.5% and 31.3%, respectively. Location significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase of 18.4% in workplace injuries and a reduction of 39.3% in home injuries over the study period. In addition, we observed relatively more workplace injuries and fewer home injuries during the pandemic (11.3% and 42.8% compared with 7.1% and 52.4%, respectively). Mortality was similar between the two periods (1.8% compared with 1.2%, p = 0.16, Fisher's exact test). CONCLUSIONS: The COVID-19 pandemic has modified the trauma risk exposure in our population. It reduced trauma hospital admissions by around 27%. Work-related injuries, including falling objects and machinery injuries, were relatively higher during the pandemic. Prevention of work-related injuries should be an important component of preparedness for future pandemics.

Changes in Injury Patterns Associated With Elevated Blood Alcohol Level.

INTRODUCTION: This study aims to improve public health outreach in a high-risk population. METHODS: This is a single center study of Trauma Registry data, inclusive years January 1, 2016 to March 30, 2021. The study population was stratified into two groups: ETOH ≥ 80 mg/dL and ETOH <80 mg/dL. A total of 1141 were included. RESULTS: Those above the legal drinking limit had a significantly higher mean ETOH (231 mg/dL; P <.01) and were typically younger men that arrived by ground ambulance. The significant injury patterns of those above the legal limit included full activation and consults who fell from stairs and fell from other or unknown. A higher proportion of intoxicated fall trauma patients above the legal limit were diagnosed with a concussion. CONCLUSIONS: Excess alcohol consumption, particularly during a pandemic year, may lead to a higher incidence of fall from stairs trauma in men who are more likely to be diagnosed with a concussion.

Relationship between mobility and road traffic injuries during COVID-19 pandemic-The role of attendant factors.

This study investigates the important role of attendant factors, such as road traffic victims' access to trauma centres, the robustness of health infrastructure, and the responsiveness of police and emergency services in the incidence of Road Traffic Injuries (RTI) during the pandemic-induced COVID-19 lockdowns. The differential effects of the first and second waves of the pandemic concerning perceived health risk and legal restrictions provide us with a natural experiment that helps us differentiate between the impact of attendant factors and the standard relationship between mobility and Road Traffic Injuries. The authors use the auto-regressive recurrent neural network method on two population levels-Tamil Nadu (TN), a predominantly rural state, and Chennai, the most significant metropolitan city of the state, to draw causal inference through counterfactual predictions on daily counts of road traffic deaths and Road Traffic Injuries. During the first wave of the pandemic, which was less severe than the second wave, the traffic flow was correlated to Road Traffic Death/Road Traffic Injury. In the second wave's partial and post lockdown phases, an unprecedented fall of over 70% in Road Traffic Injury-Grievous as against Road Traffic Injury-Minor was recorded. Attendant factors, such as the ability of the victim to approach relief centres, the capability of health and other allied infrastructures, transportation and medical treatment of road traffic crash victims, and minimal access to other emergency services, including police, assumed greater significance than overall traffic flow in the incidence of Road Traffic Injury in the more severe second wave. These findings highlight the significant role these attendant factors play in producing the discrepancy between the actual road traffic incident rate and the officially registered rate. Thus, our study enables practitioners to observe the mobility-adjusted actual incidence rate devoid of factors related to reporting and registration of accidents.

Unintended Consequences of COVID-19 on Pediatric Falls From Windows: A Multicenter Study.

INTRODUCTION: In attempts to quell the spread of COVID-19, shelter-in-place orders were employed in most states. Increased time at home, in combination with parents potentially balancing childcare and work-from-home duties, may have had unintended consequences on pediatric falls from windows. We aimed to investigate rates of falls from windows among children during the first 6 mo of the COVID-19 pandemic. METHODS: Patients <18 y old admitted to three pediatric trauma centers (two - level 1, one - level 2) between 3/19/20 and 9/19/20 (COVID-era) were compared to a pre-COVID cohort (3/19/19 to 9/19/19). The primary outcome was the rate of falls from windows. Secondary outcomes included injury severity score (ISS), injuries sustained, and mortality. RESULTS: Of 1011 total COVID-era pediatric trauma patients, 36 (3.6%) sustained falls from windows compared to 23 of 1108 (2.1%) pre-COVID era patients (OR 1.7, P = 0.05). The median ISS was seven pre-COVID versus four COVID-era (P = 0.43). The most common injuries sustained were skull fractures (30.5%), extremity injuries (30.5%), and intracranial hemorrhage (23.7%). One-fifth of patients underwent surgery (21.7% pre-COVID versus 19.4% COVID-era, P = 1.0). There was one mortality in the COVID-era cohort and none in the pre-COVID cohort (P = 1.0). CONCLUSIONS: Despite overall fewer trauma admissions during the first 6 mo of the COVID-19 pandemic, the rate of falls from windows nearly doubled compared to the prior year, with substantial associated morbidity. These findings suggest a potential unintended consequence of shelter-in-place orders and support increased education on home safety and increased support for parents potentially juggling multiple responsibilities in the home.

PERSIAN Traffic Safety and Health Cohort: a study protocol on postcrash mental and physical health consequences.

BACKGROUND: Cohort studies play essential roles in assessing causality, appropriate interventions. The study, Post-crash Prospective Epidemiological Research Studies in IrAN Traffic Safety and Health Cohort, aims to investigate the common health consequences of road traffic injuries (RTIs) postcrash through multiple follow-ups. METHODS: This protocol study was designed to analyse human, vehicle and environmental factors as exposures relating to postcrash outcomes (injury, disability, death, property damage, quality of life, etc). Population sources include registered injured people and followed up healthy people in precrash cohort experienced RTIs. It includes four first-year follow-ups, 1 month (phone-based), 3 months (in-person, video/phone call), 6 and 12 months (phone-based) after crash. Then, 24-month and 36-month follow-ups will be conducted triennially. Various questionnaires such as Post-traumatic Stress Disorder Questionnaire, Patient Health Questionnaire, WHO Disability Assessment Schedules, Cost-related Information, etc are completed. Counselling with a psychiatrist and a medical visit by a practitioner are provided accompanied by extra tools (simulator-based driving assessment, and psychophysiological tests). Through preliminary recruitment plan, 5807, 2905, 2247 and 1051 subjects have been enrolled, respectively at the baseline, first, second and third follow-ups by now. At baseline, cars and motorcycles accounted for over 30% and 25% of RTIs. At first follow-up, 27% of participants were pedestrians engaged mostly in car crashes. Around a fourth of injuries were single injuries. Car occupants were injured in 40% of collisions. DISCUSSION: The study provides an opportunity to investigate physical-psychosocial outcomes of RTIs, predictors and patterns at follow-up phases postinjury through longitudinal assessments, to provide advocates for evidence-based safety national policy-making.

DINED (Delivery-related INjuries in the Emergency Department) part 2: A chart review of risk factors and injuries affecting food delivery riders.

OBJECTIVE: This study aimed to examine patterns of injury, the impact of these injuries on patients and identification of potentially modifiable contributing factors through industry regulation reforms and education. METHODS: Food delivery rider (FDR)-related presentations to the Royal Brisbane and Women's Hospital Emergency and Trauma Centre for a year from September 2020 were identified. Data collected included patient and incident demographics: time, type and location of injuries, investigations and care required, length of stay, admission requirements and follow up. RESULTS: The cohort included 81.8% male with a mean age of 25.2 years. Most injuries occurred on the road from a collision with a vehicle. The most common injury was fractures. Incidence increased on weekends and during the evening. More than half the cohort were admitted to hospital. Only 22.7% of patients were eligible for workers compensation and less than half were covered by Medicare. The majority (72.7%) of cases involved non-resident riders from other countries. CONCLUSION: The majority of FDRs presenting with injuries are not Australian citizens and less than half were Medicare eligible potentially contributing to inadequate access to care especially fracture follow up. There were spikes in injuries occurring at night, weekends and during periods of pandemic associated lockdowns demonstrating an increased usage of delivery services during these times. Results highlight injury patterns experienced by delivery riders and potentially modifiable risk factors for this rapidly growing area of employment within the gig economy.

Changes in the characteristics of trauma patients after the early COVID-19 outbreak: A retrospective study of a regional level 1 trauma center in Republic of Korea.

ABSTRACT: Gyeonggi-do (Gyeonggi province) has the second highest number of coronavirus disease (COVID-19) cases in the Republic of Korea after Seoul, with approximately 25% of the COVID-19 patients as of January 2021. Our center is a level I trauma center located in south Gyeonggi-do, and we aimed to evaluate whether the characteristics of trauma patients changed after the COVID-19 pandemic.We retrospectively reviewed the trauma patients registered with the Korea Trauma Database of the Center from February 2019 to January 2021. The patients were dichotomized into pre-coronavirus disease (pre-COVID) and coronavirus disease (COVID) groups, and their trauma volumes, injury characteristics, intentionality, and outcomes were compared.A total of 2628 and 2636 patients were included in the pre-COVID and COVID groups, respectively. During the COVID-19 period, motorcycle accidents, bicycle accidents, and penetrating injury cases increased, and pedestrian traffic accidents, slips, and injury by machines decreased. The average daily number of patients in the COVID group was lower in March (5.6 ±â€Š2.6/day vs 7.2 ±â€Š2.4/day, P = .014) and higher in September (9.9 ±â€Š3.2/day vs 7.7 ±â€Š2.0/day, P = .003) compared to the pre-COVID group. The COVID group also had a higher ratio of direct admissions (67.5% vs 57.2%, P < .001), proportion of suicidal patients (4.1% vs 2.7%, P = .005), and injury severity scores (14 [9-22] vs 12 [4-22], P < .001) than the pre-COVID group. The overall mortality (4.7% vs 4.9%, P = .670) and intensive care unit length of stay (2 [0-3] days vs 2 [0-4] days, P = .153) was not different between the 2 groups.Although the total number of patients did not change, the COVID-19 pandemic affected the number of monthly admissions and the injury mechanisms changed. More severely injured patients were admitted directly to the trauma center.

An Epidemic Within the Pandemic: The Rising Tide of Trauma During COVID-19.

BACKGROUND: In the age of COVID-19 and enforced social distancing, changes in patterns of trauma were observed but poorly understood. Our aim was to characterize traumatic injury mechanisms and acuities in 2020 and compare them with previous years at our level I trauma center. MATERIAL AND METHODS: Patients with trauma triaged in 2016 through 2020 from January to May were reviewed. Patient demographics, level of activation (1 versus 2), injury severity score, and mechanism of injury were collected. Data from 2016 through 2019 were combined, averaged by month, and compared with data from 2020 using chi-squared analysis. RESULTS: During the months of interest, 992 patients with trauma were triaged in 2020 and 4311 in 2016-2019. The numbers of penetrating and level I trauma activations in January-March of 2020 were similar to average numbers for the same months during 2016 through 2019. In April 2020, there was a significant increase in the incidence of penetrating trauma compared with the prior 4-year average (27% versus 16%, P < 0.002). Level I trauma activations in April 2020 also increased, rising from 17% in 2016 through 2019 to 32% in 2020 (P < 0.003). These findings persisted through May 2020 with similarly significant increases in penetrating and high-level trauma. CONCLUSIONS: In the months after the initial spread of COVID-19, there was a perceptible shift in patterns of trauma. The significant increase in penetrating and high-acuity trauma may implicate a change in population dynamics, demanding a need for thoughtful resource allocation at trauma centers nationwide in the context of a global pandemic.

COVID-19: using chest CT of major trauma patients to monitor and evaluate the second wave in London and the development of routine monitoring in practice.

AIM: To follow-up previous work evaluating incidental findings of COVID-19 signs on computed tomography (CT) images of major trauma patients to include the second wave prior to any major effects from vaccines. MATERIALS AND METHODS: The study population included all patients admitted following major trauma between 1 January 2020 and 28 February 2021 with CT including the lungs (n=1776). Major trauma patients admitted pre-COVID-19 from alternate months from January 2019 to November 2019 comprised a control group (n=837). The assessing radiologists were blinded to the time period and used double reading in consensus to determine if the patient had signs of COVID-19. Lung appearances were classified as no evidence of COVID-19, minor signs, or major signs. RESULTS: The method successfully tracked the second wave of the COVID-19 pandemic in London. The estimated population affected by the disease based on those with major signs was similar to estimates of the proportion of the population in London with antibodies (around 30% by end February 2021) and the total of major and minor signs produced a much higher figure of 68%, which may include all those with both antibody and just T-cell responses. CONCLUSIONS: Incidental findings on CT from major trauma patients may provide a novel and sensitive way of tracking the virus. It is recommended that all major trauma units include a simple question on signs of COVID-19 to provide an early warning system for further waves.