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1.
Inj Prev ; 28(3): 269-279, 2022 06.
Article in English | MEDLINE | ID: covidwho-1861642

ABSTRACT

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.


Subject(s)
Pedestrians , Wounds and Injuries , Accidents, Traffic , Humans , Motorcycles , Prospective Studies , Quality of Life , Wounds and Injuries/epidemiology
2.
PLoS One ; 17(5): e0268190, 2022.
Article in English | MEDLINE | ID: covidwho-1855025

ABSTRACT

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.


Subject(s)
COVID-19 , Wounds and Injuries , Accidents, Traffic , COVID-19/epidemiology , Communicable Disease Control , Humans , India , Pandemics , Wounds and Injuries/epidemiology
3.
Medicine (Baltimore) ; 101(2): e28567, 2022 Jan 14.
Article in English | MEDLINE | ID: covidwho-1625627

ABSTRACT

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.


Subject(s)
COVID-19 , Patient Admission/statistics & numerical data , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , Adult , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Republic of Korea/epidemiology , Retrospective Studies , SARS-CoV-2 , Wounds and Injuries/diagnosis , Wounds and Injuries/therapy
4.
J Surg Res ; 272: 139-145, 2022 04.
Article in English | MEDLINE | ID: covidwho-1620890

ABSTRACT

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.


Subject(s)
COVID-19 , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , COVID-19/epidemiology , Humans , Injury Severity Score , Pandemics , Retrospective Studies , SARS-CoV-2
5.
Clin Radiol ; 77(3): 231-235, 2022 03.
Article in English | MEDLINE | ID: covidwho-1568610

ABSTRACT

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.


Subject(s)
COVID-19/epidemiology , Lung/diagnostic imaging , Tomography, X-Ray Computed , Wounds and Injuries/diagnostic imaging , Wounds and Injuries/epidemiology , Aged, 80 and over , COVID-19/diagnostic imaging , Comorbidity , Female , Humans , Incidental Findings , London/epidemiology , Male , Middle Aged , Pandemics , Prevalence , United Kingdom/epidemiology
6.
BMC Emerg Med ; 21(1): 102, 2021 09 09.
Article in English | MEDLINE | ID: covidwho-1533244

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had profound effects on the utilization of health care services, including Emergency Medical Services (EMS). Social distancing measures taken to prevent the spread of the disease have greatly affected the functioning of societies and reduced or halted many activities with a risk of injury. The aim of this study was to report the effects of lockdown measures on trauma-related EMS calls in the Finnish capital area. METHODS: We conducted a retrospective cohort study of all EMS calls in the Helsinki University Hospital (HUH) catchment area between 1 January and 31 July 2020. Calls were identified from the HUH EMS database. Calls were grouped into pre-lockdown, lockdown, and post-lockdown periods according to the restrictions set by the Finnish government and compared to the mean number of calls for the corresponding periods in 2018 and 2019. Statistical comparisons were performed using Mann-Whitney U-test for weekly numbers and percentages. RESULTS: During the study period there was a total of 70,705 EMS calls, of which 14,998 (21.2%) were related to trauma; 67,973 patients (median age 61.6 years; IQR 35.3-78.6) were met by EMS. There was no significant change in the weekly number of total or trauma-related EMS calls during the pre-lockdown period. During the lockdown period, the number of weekly total EMS calls was reduced by 12.2% (p = 0.001) and the number of trauma-related calls was reduced by 23.3% (p = 0.004). The weekly number of injured patients met by EMS while intoxicated with alcohol was reduced by 41.8% (p = 0.002). During the post-lockdown period, the number of total and trauma-related calls and the number of injured patients intoxicated by alcohol returned to previous years' levels. CONCLUSIONS: The COVID-19 pandemic and social distancing measures reduced the number of trauma-related EMS calls. Lockdown measures had an especially significant effect on the number of injured patients intoxicated by alcohol met by the EMS. TRIAL REGISTRATION: Not applicable.


Subject(s)
COVID-19 , Emergency Medical Services , Wounds and Injuries/epidemiology , Communicable Disease Control , Emergency Medical Services/statistics & numerical data , Finland/epidemiology , Humans , Middle Aged , Pandemics , Retrospective Studies
7.
Arch Dis Child ; 106(11): 1050-1055, 2021 11.
Article in English | MEDLINE | ID: covidwho-1501685

ABSTRACT

BACKGROUND: Globally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5-24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited. METHODS: A new model of injury surveillance for use in emergency departments in Nepal was designed and piloted. Data from patients presenting with injuries were collected prospectively over 12 months and used to describe the epidemiology of paediatric injury presentations. RESULTS: The total number of children <18 years of age presenting with injury was 2696, representing 27% of all patients presenting with injuries enrolled. Most injuries in children presenting to the emergency departments in this study were unintentional and over half of children were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with poisonings, burns and drownings presenting proportionately less often. Over half of injuries were cuts, bites and open wounds. In-hospital child mortality from injury was 1%. CONCLUSION: Injuries affecting children in Nepal represent a significant burden. The data on injuries observed from falls, road traffic injuries and injuries related to animals suggest potential areas for injury prevention. This is the biggest prospective injury surveillance study in Nepal in recent years and supports the case for using injury surveillance to monitor child morbidity and mortality through improved data.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Global Burden of Disease/economics , Public Health Surveillance/methods , Wounds and Injuries/epidemiology , Accidental Falls/statistics & numerical data , Accidents, Traffic/statistics & numerical data , Adolescent , Animals , Bites and Stings/epidemiology , Burns/epidemiology , Child , Child, Preschool , Drowning/epidemiology , Emergency Service, Hospital/trends , Female , Humans , Male , Nepal/epidemiology , Poisoning/epidemiology , Prospective Studies , Trauma Severity Indices , Wounds and Injuries/mortality , Wounds and Injuries/prevention & control
8.
BMC Pediatr ; 21(1): 422, 2021 09 24.
Article in English | MEDLINE | ID: covidwho-1438263

ABSTRACT

BACKGROUND: To explore the characteristics of unintentional childhood-injury during the COVID-19 pandemic and assess the association of unintentional-injury with maternal emotional status. METHODS: A cross-sectional survey was conducted with a convenience sample of 1300 children under 12-years-old from 21 schools (including nurseries/ kindergartens/ primary schools) in Wuhan and Shanghai during March to April 2020, and the mothers completed questionnaires online. Self-rating Depression/Anxiety Scales were used to evaluate maternal emotional status, questions on child unintentional-injury were based on the International-Statistical-Classification-of-Diseases-and-Related-Health-Problems-version-10 (ICD-10), and a total of 11 kinds of unintentional injuries were inquired. Information on socio-demographic and family-background factors was also collected. RESULTS: The children of 0-4, 5-9, and 10-12 years accounted for 29.2, 55.2 and 15.6%, respectively, the unintentional-injury rates were 10.29, 4.18 and 3.45%, respectively (P < 0.001), and boys had higher rates than girls. The three leading causes included "being struck by/against", falls and animal bites (traffic-injury accounted for a small proportion). Lower maternal educational, living in suburban/rural (vs. urban) areas, grandparents (vs. mothers) being main caregivers, more child exposure to secondhand smoke, close relatives being suspected/ confirmed COVID-19 cases were associated with a higher risk of child unintentional-injury. After adjusting for related confounders, higher maternal depression levels were associated with a higher risk of unintentional injury. CONCLUSIONS: The characteristics of unintentional childhood injury were different from those in non-pandemic periods. The main causes, risk factors and the association of unintentional injury with maternal depression deserve attention for development of effective measures for preventing children from unintentional injury during COVID-19 pandemic.


Subject(s)
COVID-19 , Wounds and Injuries , Child , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Mothers , Pandemics , Risk Factors , SARS-CoV-2 , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology
9.
West J Emerg Med ; 22(5): 1060-1066, 2021 Sep 02.
Article in English | MEDLINE | ID: covidwho-1405511

ABSTRACT

INTRODUCTION: Very little is known about the effects of the novel coronavirus (COVID-19) pandemic and its associated social distancing practices on trauma presentations to the emergency department (ED). This study aims to assess the impact of a city-wide stay at home order on the volume, type, and outcomes of traumatic injuries at urban EDs. METHODS: The study was a retrospective chart review of all patients who presented to the ED of an urban Level I Trauma Center and its urban community affiliate in the time period during the 30 days before the institution of city-wide shelter-in-place (preSIP) order and 60 days after the shelter-in-place (SIP) order and the date-matched time periods in the preceding year. Volume and mechanism of traumatic injuries were compared using paired T-tests. RESULTS: There was a significant decrease in overall ED volume. The volume of certain blunt trauma presentations (motor vehicle collisions) during the first 60 days of SIP compared to the same period from the year prior also significantly decreased. Importantly, the volume of penetrating injuries, including gunshot wounds and stab wounds, did not differ for the preSIP and SIP periods when compared to the prior year. The mortality of traumatic injuries was also unchanged during the SIP comparison period. CONCLUSION: While there were significant decreases in visits to the ED and overall trauma volume, penetrating trauma, including gun violence, and other severe traumatic injuries remain a public health crisis that affects urban communities despite social distancing recommendations enacted during the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Emergency Service, Hospital/statistics & numerical data , Pandemics/prevention & control , Quarantine , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , COVID-19/epidemiology , Emergency Service, Hospital/trends , Humans , Retrospective Studies , SARS-CoV-2 , Urban Population
10.
Swiss Med Wkly ; 151(33-34)2021 08 27.
Article in English | MEDLINE | ID: covidwho-1399509

ABSTRACT

INTRODUCTION: The COVID-19 pandemic and the associated restrictions may have modified the activities of the Swiss population and thus altered trauma patterns. MATERIALS AND PATIENTS: All adult patients with major trauma admitted to our institution in 2019 and 2020 were assessed using the Injury Severity Score (ISS), by body region involved, type of injury, age, admission to an intensive care unit and 30-day mortality. RESULTS: In 2020, 454 patients with major trauma were admitted to our institution, 17% fewer than in the previous year. The drop in the number of major trauma patients proceeded with and overlapped both the first and second peaks in incidence of the pandemic and the associated restrictions. The median ISS was higher in 2020 (25, interquartile range [IQR] 17-26.5) than in 2019 (22, IQR 16-26, p = 0.04). There were no significant differences in body region involved, type of injury or age (p >0.05). In 2020, a higher percentage of patients were admitted to an intensive care unit (86.5% vs 77.7%, p <0.001) and died within 30 days (8.8% vs 5.0%, p = 0.015). The 30-day mortality was higher in 2020 than in 2019, with an odds ratio of 1.80 (95% confidence interval 1.04-3.10, p= 0.036) after adjustment for the following potential confounders: ISS, age, gender and type of injury. CONCLUSION: In the first year of the COVID-19 pandemic, fewer patients with major trauma were admitted to our institution. However, the patients admitted were more severely injured and more often died within 30 days. Understanding the differences in injury patterns and admissions in major trauma patients under special conditions - such as a pandemic - could help to allocate rare resources adequately.


Subject(s)
COVID-19 , Wounds and Injuries , Adult , Cohort Studies , Humans , Injury Severity Score , Pandemics , Retrospective Studies , SARS-CoV-2 , Switzerland/epidemiology , Trauma Centers , Wounds and Injuries/epidemiology
11.
PLoS One ; 16(3): e0248162, 2021.
Article in English | MEDLINE | ID: covidwho-1394534

ABSTRACT

MAVIE is a web-based prospective cohort study of Home, Leisure, and Sports Injuries with a longitudinal follow-up of French general population volunteers. MAVIE participants are voluntary members of French households, including overseas territories. Participation in the cohort involves answering individual and household questionnaires and relevant exposures and prospectively reporting injury events during the follow-up. Recruitment and data collection have been in progress since 2014. The number of participants as of the end of the year 2019 was 12,419 from 9,483 households. A total of 8,640 participants provided data during follow-up. Respondents to follow-up were composed of 763 children aged 0-14, 655 teenagers and young adults aged 15-29, 6,845 adults, and 377 people aged 75 or more. At the end of the year 2019, 1,698 participants had reported 2,483 injury events. Children, people aged 50 and more, people with poor self-perceived physical and mental health, people who engage in sports activities, and people with a history of injury during the year before recruitment were more likely to report new injuries. An interactive mobile/web application (MAVIE-Lab) was developed to help volunteers decide on personalized measures to prevent their risks of HLIs. The available data provides an opportunity to analyse multiple exposures at both the individual and household levels that may be associated with an increased risk of trauma. The ongoing analysis includes HLI incidence estimates, the determination of health-related risk factors, a specific study on the risk of home injury, another on sports injuries, and an analysis of the role of cognitive skills and mind wandering. Volunteers form a community that constitutes a population laboratory for preventative initiatives.


Subject(s)
Accidents, Home/statistics & numerical data , Athletic Injuries/epidemiology , Leisure Activities , Wounds and Injuries/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , France/epidemiology , Health Status , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Middle Aged , Mobile Applications , Prospective Studies , Risk Factors , Surveys and Questionnaires , Wounds and Injuries/etiology , Young Adult
12.
Accid Anal Prev ; 162: 106391, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1384788

ABSTRACT

The current study aims to investigate the impact of the COVID-19 pandemic on road traffic collisions, fatalities, and injuries using time series analyses. To that aim, a database containing road collisions, fatalities, and slight injuries data from Greece were derived from the Hellenic Statistical Authority (HSA) and covered a ten-year timeframe (from January 2010 to August 2020. The chosen time period contained normal operations, as well as the period of the first COVID-19-induced lockdown period in Greece. Three different Seasonal Autoregressive Integrated Moving Average (SARIMA) time series models were implemented in order to compare the observed measurements to forecasted values that were intended to depict assumed conditions; namely, without the appearance of the COVID-19 pandemic. Modelling results revealed that the total number of road collisions, fatalities, and slightly injured were decreased, mainly due to the sharp traffic volume decrease. However, the percentage reduction of the collision variables and traffic volume were found to be disproportionate, which probably indicates that more collisions occurred with regard to the prevailing traffic volume. An additional finding is that fatalities and slightly injured rates were significantly increased during the lockdown period and the subsequent month. Overall, it can be concluded that a worse performance was identified in terms of road safety. Since subsequent waves of COVID-19 cases and other pandemics may reappear in the future, the outcomes of the current study may be exploited for the improvement of road safety from local authorities and policymakers.


Subject(s)
COVID-19 , Wounds and Injuries , Accidents, Traffic , Communicable Disease Control , Greece/epidemiology , Humans , Pandemics , SARS-CoV-2 , Wounds and Injuries/epidemiology
13.
Injury ; 51(6): 1243-1244, 2020 06.
Article in English | MEDLINE | ID: covidwho-1382432
14.
PLoS One ; 16(8): e0256610, 2021.
Article in English | MEDLINE | ID: covidwho-1367710

ABSTRACT

The impacts of COVID-19 on travel demand, traffic congestion, and traffic safety are attracting heated attention. However, the influence of the pandemic on electric bike (e-bike) safety has not been investigated. This paper fills the research gap by analyzing how COVID-19 affects China's e-bike safety based on a province-level dataset containing e-bike safety metrics, socioeconomic information, and COVID-19 cases from 2017 to 2020. Multi-output regression models are adopted to investigate the overall impact of COVID-19 on e-bike safety in China. Clustering-based regression models are used to examine the heterogeneous effects of COVID-19 and the other explanatory variables in different provinces/municipalities. This paper confirms the high relevance between COVID-19 and the e-bike safety condition in China. The number of COVID-19 cases has a significant negative effect on the number of e-bike fatalities/injuries at the country level. Moreover, two clusters of provinces/municipalities are identified: one (cluster 1) with lower and the other (cluster 2 that includes Hubei province) higher number of e-bike fatalities/injuries. In the clustering-based regressions, the absolute coefficients of the COVID-19 feature for cluster 2 are much larger than those for cluster 1, indicating that the pandemic could significantly reduce e-bike safety issues in provinces with more e-bike fatalities/injuries.


Subject(s)
Accidents, Traffic/statistics & numerical data , Bicycling/statistics & numerical data , COVID-19/epidemiology , Wounds and Injuries/epidemiology , China/epidemiology , Cluster Analysis , Humans , Mortality , Regression Analysis , Seasons , Socioeconomic Factors , Wounds and Injuries/mortality
15.
Int J Equity Health ; 20(1): 180, 2021 08 03.
Article in English | MEDLINE | ID: covidwho-1365357

ABSTRACT

BACKGROUND: Ethiopia has experienced great improvements in life expectancy (LE) at birth over the last three decades. Despite consistent increases in LE for both males and females in Ethiopia, the country has simultaneously witnessed an increasing discrepancy in LE between males and females. METHODS: This study used Pollard's actuarial method of decomposing LE to compare age- and cause- specific contributions to changes in sex differences in LE between 1995 and 2015 in Ethiopia. RESULTS: Life expectancy at birth in Ethiopia increased for both males and females from 48.28 years and 50.12 years in 1995 to 65.59 years and 69.11 years in 2015, respectively. However, the sex differences in LE at birth also increased from 1.85 years in 1995 to 3.51 years in 2015. Decomposition analysis shows that the higher male mortality was consistently due to injuries and respiratory infections, which contributed to 1.57 out of 1.85 years in 1995 and 1.62 out of 3.51 years in 2015 of the sex differences in LE. Increased male mortality from non-communicable diseases (NCDs) also contributed to the increased difference in LE between males and females over the period, accounting for 0.21 out of 1.85 years and 1.05 out of 3.51 years in 1995 and 2015, respectively. CONCLUSIONS: While injuries and respiratory infections causing male mortality were the most consistent causes of the sex differences in LE in Ethiopia, morality from NCDs is the main cause of the recent increasing differences in LE between males and females. However, unlike the higher exposure of males to death from injuries due to road traffic injuries or interpersonal violence, to what extent sex differences are caused by the higher male mortality compared to female mortality from respiratory infection diseases is unclear. Similarly, despite Ethiopia's weak social security system, an explanation for the increased sex differences after the age of 40 years due to either longer female LE or reduced male LE should be further investigated.


Subject(s)
Communicable Diseases , Health Status Disparities , Life Expectancy , Noncommunicable Diseases , Wounds and Injuries , Adolescent , Adult , Aged , Child , Child, Preschool , Communicable Diseases/epidemiology , Ethiopia/epidemiology , Female , Humans , Infant , Infant, Newborn , Life Expectancy/trends , Male , Middle Aged , Noncommunicable Diseases/epidemiology , Sex Distribution , Wounds and Injuries/epidemiology , Young Adult
16.
Traffic Inj Prev ; 22(7): 501-506, 2021.
Article in English | MEDLINE | ID: covidwho-1364677

ABSTRACT

OBJECTIVE: Little is known about the relationship between Stay-At-Home orders issued by state governments due to the COVID-19 pandemic and their impacts on motor vehicle-related injuries. The purpose of this study was to determine whether the presence of a Stay-At-Home order was associated with lower rates of motor vehicle-related injuries requiring emergency medical treatment among population sub-groups in West Virginia (i.e., males, females, 0-17, 18-25, 26-45, 46-65, ≥66 years old). METHODS: A Stay-At-Home order was in effect in West Virginia from March 23-May 4, 2020. Counts of individuals who incurred motor-vehicle-related injuries that required emergency medical treatment were obtained from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program from January 1 thru September 6 of 2019 and 2020. Counts were obtained by week-year and by population sub-group in West Virginia. The presence of the Stay-At-Home order was binary coded by week. Negative binomial regression was used to assess the relationship between the presence of a Stay-At-Home and injury rates. 2019 population sub-group estimates were obtained from the United States Census Bureau and used as offsets in the models. Models were also adjusted for year and vehicle miles traveled by week-year. RESULTS: There were 23,418 motor-vehicle related injuries during the study period. The presence of the Stay-At-Home order was associated with 44% less injuries overall [Incident Rate Ratio (IRR)=0.56, 95% CI 0.48, 0.64]. Females experienced fewer injuries than males (IRR = 0.49 vs 0.63, respectively) and the number of injuries decreased with age (p-value 0.031) when comparing time periods when the Stay-At-Home was in effect compared to times when it was not. CONCLUSIONS: West Virginia's Stay-At-Home order was associated with lower motor-vehicle injury rates requiring medical treatment across all population sub-groups. Most population sub-groups likely altered their travel behaviors which resulted in lower motor-vehicle injury rates. These findings may inform future policies that impose emergency travel restrictions in populations.


Subject(s)
Accidents, Traffic , COVID-19 , Pandemics , Public Health , Wounds and Injuries , Accidents, Traffic/statistics & numerical data , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pandemics/prevention & control , Public Health/legislation & jurisprudence , West Virginia/epidemiology , Wounds and Injuries/epidemiology , Young Adult
18.
J Surg Res ; 269: 165-170, 2022 01.
Article in English | MEDLINE | ID: covidwho-1347730

ABSTRACT

BACKGROUND: With the onset of the COVID-19 pandemic and subsequent widespread stay-at-home advisories throughout early 2020, hospitals have noticed a decrease in illnesses unrelated to COVID-19. However, the impact on traumatic injury is relatively unknown. This study aims to characterize patterns of trauma during the COVID-19 pandemic at a Level I Trauma Center. MATERIALS & METHODS: A retrospective review was performed of adult trauma patients from March to June, in the years 2018 through 2020. Primary outcome was the number of trauma activations (volume). Secondary outcomes included activation level, mechanism of injury, mortality rate, and length of stay, and other demographic background. Trauma patterns of the 2018 and 2019 periods were combined as historical control, and compared to patterns of the biweekly-matched period of 2020. RESULTS: A total of 2,187 patients were included in analysis (Pre-COVID n = 1,572; COVID n = 615). Results were significant for decreased trauma volume but longer length of stay during COVID cohort, and for an increased proportion of males. No significant difference was found for other demographic variables, trauma mechanisms, or severity. Trauma volume patterns mirrored COVID rates in the state. CONCLUSIONS: Despite a decline in trauma volume, other trauma patterns including severity and mechanism remained unchanged during the COVID-19 period. The decreased volume was not associated with a markedly lower clinical workload, change in team structure, or provider coverage re-distribution. Our data suggests that trauma volume and severity remained high enough during COVID-19 peak to necessitate full staffing, which may provide guidance in the event of a pandemic resurgence.


Subject(s)
COVID-19 , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , Adult , COVID-19/prevention & control , Communicable Disease Control , Female , Humans , Male , New England/epidemiology , Pandemics , Retrospective Studies
19.
BMC Emerg Med ; 21(1): 88, 2021 07 26.
Article in English | MEDLINE | ID: covidwho-1327808

ABSTRACT

BACKGROUND: To present the new trends in epidemiology of road traffic injuries (RTIs) during the Coronavirus disease 2019 (COVID-19) pandemic in Suzhou. METHODS: Pre-hospital records of RTIs from January to May in 2020 and the same period in 2019 were obtained from the database of Suzhou pre-hospital emergency center, Jiangsu, China. Data were extracted for analysis, including demographic characteristics, pre-hospital vital signs, transport, shock index, consciousness, pre-hospital death. A retrospective study comparing epidemiological characteristics of RTIs in Suzhou during the 5-month period in 2020 to the parallel period in 2019 was performed. RESULTS: A total of 7288 RTIs in 2020 and 8869 in 2019 met inclusion criteria. The overall volume of RTIs has statistical difference between the 2 years (p < 0.001), with fewer RTIs in 2020 compared with 2019. Electric bicycle related RTIs increased during the pandemic (2641, 36.24% vs 2380, 26.84%, p < 0.001), with a higher incidence of RTIs with disorder of consciousness (DOC) (7.22% vs 6.13%, p = 0.006). CONCLUSIONS: Under the impact of COVID-19, the total number of RTIs in Suzhou from January to May 2020 decreased. This observation was coupled with a rise in electric bicycle related injuries and an increase in the incidence of RTIs with DOC.


Subject(s)
Accidents, Traffic/statistics & numerical data , Bicycling/statistics & numerical data , COVID-19/epidemiology , Wounds and Injuries/epidemiology , China , Humans , Incidence , Motorcycles/statistics & numerical data , Retrospective Studies , Risk Factors
20.
World J Emerg Surg ; 16(1): 39, 2021 07 19.
Article in English | MEDLINE | ID: covidwho-1318287

ABSTRACT

BACKGROUNDS: The COVID-19 pandemic drastically strained the health systems worldwide, obligating the reassessment of how healthcare is delivered. In Lombardia, Italy, a Regional Emergency Committee (REC) was established and the regional health system reorganized, with only three hospitals designated as hubs for trauma care. The aim of this study was to evaluate the effects of this reorganization of regional care, comparing the distribution of patients before and during the COVID-19 outbreak and to describe changes in the epidemiology of severe trauma among the two periods. METHODS: A cohort study was conducted using retrospectively collected data from the Regional Trauma Registry of Lombardia (LTR). We compared the data of trauma patients admitted to three hub hospitals before the COVID-19 outbreak (September 1 to November 19, 2019) with those recorded during the pandemic (February 21 to May 10, 2020) in the same hospitals. Demographic data, level of pre-hospital care (Advanced Life Support-ALS, Basic Life Support-BLS), type of transportation, mechanism of injury (MOI), abbreviated injury score (AIS, 1998 version), injury severity score (ISS), revised trauma score (RTS), and ICU admission and survival outcome of all the patients admitted to the three trauma centers designed as hubs, were reviewed. Screening for COVID-19 was performed with nasopharyngeal swabs, chest ultrasound, and/or computed tomography. RESULTS: During the COVID-19 pandemic, trauma patients admitted to the hubs increased (46.4% vs 28.3%, p < 0.001) with an increase in pre-hospital time (71.8 vs 61.3 min, p < 0.01), while observed in hospital mortality was unaffected. TRISS, ISS, AIS, and ICU admission were similar in both periods. During the COVID-19 outbreak, we observed substantial changes in MOI of severe trauma patients admitted to three hubs, with increases of unintentional (31.9% vs 18.5%, p < 0.05) and intentional falls (8.4% vs 1.2%, p < 0.05), whereas the pandemic restrictions reduced road- related injuries (35.6% vs 60%, p < 0.05). Deaths on scene were significantly increased (17.7% vs 6.8%, p < 0.001). CONCLUSIONS: The COVID-19 outbreak affected the epidemiology of severe trauma patients. An increase in trauma patient admissions to a few designated facilities with high level of care obtained satisfactory results, while COVID-19 patients overwhelmed resources of most other hospitals.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care/trends , Intensive Care Units/statistics & numerical data , Pandemics , Registries , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , Adult , Comorbidity , Female , Hospital Mortality/trends , Hospitalization/trends , Humans , Injury Severity Score , Italy , Male , Middle Aged , Retrospective Studies , Wounds and Injuries/diagnosis , Wounds and Injuries/therapy
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