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Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden.
Abdallah, Hatem O; Zhao, Cindy; Kaufman, Elinore; Hatchimonji, Justin; Swendiman, Robert A; Kaplan, Lewis J; Seamon, Mark; Schwab, C William; Pascual, Jose L.
  • Abdallah HO; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Zhao C; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Kaufman E; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Hatchimonji J; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Swendiman RA; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Kaplan LJ; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Penn Presbyterian Medical Center, Philadelphia, PA.
  • Seamon M; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Penn Presbyterian Medical Center, Philadelphia, PA.
  • Schwab CW; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Penn Presbyterian Medical Center, Philadelphia, PA.
  • Pascual JL; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Penn Presbyterian Medical Center, Philadelphia, PA. Electronic address: jose.pascual@pennmedicine.upenn.edu
J Am Coll Surg ; 232(2): 159-168.e3, 2021 02.
Article in English | MEDLINE | ID: covidwho-1065267
ABSTRACT

BACKGROUND:

Public health measures were instituted to reduce COVID-19 spread. A decrease in total emergency department volume followed, but the impact on injury is unknown. With lockdown and social distancing potentially increasing domicile discord, we hypothesized that intentional injury increased during COVID-19, driven primarily by an increase in penetrating trauma. STUDY

DESIGN:

A retrospective review of acute adult patient care in an urban Level I trauma center assessed injury patterns. Presenting patient characteristics and diagnoses from 6 weeks pre to 10 weeks post statewide stay-at-home orders (March 16, 2020) were compared, as well as with 2015-2019. Subsets were defined by intentionality (intentional vs nonintentional) and mechanism of injury (blunt vs penetrating). Fisher exact and Wilcoxon tests were used to compare proportions and means.

RESULTS:

There were 357 trauma patients that presented pre stay-at-home order and 480 that presented post stay-at-home order. Pre and post groups demonstrated differences in sex (35.6% vs 27.9% female; p = 0.02), age (47.4 ± 22.1 years vs 42 ± 20.3 years; p = 0.009), and race (1.4% vs 2.3% Asian; 63.3% vs 68.3% Black; 30.5% vs 22.3% White; and 4.8% vs 7.1% other; p = 0.03). Post stay-at-home order mechanism of injury revealed more intentional injury (p = 0.0008). Decreases in nonintentional trauma after adoption of social isolation paralleled declines in daily emergency department visits. Compared with earlier years, 2020 demonstrated a significantly greater proportion of intentional violent injury during the peripandemic months, especially from firearms.

CONCLUSIONS:

Unprecedented social isolation policies to address COVID-19 were associated with increased intentional injury, especially gun violence. Meanwhile, emergency department and nonintentional trauma visits decreased. Pandemic-related public health measures should embrace intentional injury prevention and management strategies.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Urban Population / Wounds, Gunshot / Firearms / Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Am Coll Surg Journal subject: Gynecology / Obstetrics Year: 2021 Document Type: Article Affiliation country: J.jamcollsurg.2020.09.028

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urban Population / Wounds, Gunshot / Firearms / Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Am Coll Surg Journal subject: Gynecology / Obstetrics Year: 2021 Document Type: Article Affiliation country: J.jamcollsurg.2020.09.028