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The effect of the COVID-19 pandemic on mental health associated trauma, admissions and fractures at a London major trauma centre.
Hay, D; Jamal, M S; Al-Tawil, K; Petohazi, A; Gulli, V; Bednarczuk, N F; Baldwin-Smith, R; Gibbons, J; Sinha, J.
  • Hay D; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
  • Jamal MS; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
  • Al-Tawil K; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
  • Petohazi A; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
  • Gulli V; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
  • Bednarczuk NF; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
  • Baldwin-Smith R; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
  • Gibbons J; GKT School of Medical Education, Kings College London, London, UK.
  • Sinha J; Department of Trauma and Orthopaedic Surgery, Kings College Hospital NHS Foundation Trust, London, UK.
Ann R Coll Surg Engl ; 103(2): 114-119, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1073077
ABSTRACT

INTRODUCTION:

Non-injury-related factors have been extensively studied in major trauma and have been shown to have a significant impact on patient outcomes. Mental illness and associated medication use has been proven to have a negative effect on bone health and fracture healing. MATERIALS AND

METHODS:

We collated data retrospectively from the records of orthopaedic inpatients in a non-COVID and COVID period. We analysed demographic data, referral and admission numbers, orthopaedic injuries, surgery performed and patient comorbidities, including psychiatric history.

RESULTS:

There were 824 orthopaedic referrals and 358 admissions (six/day) in the non-COVID period, with 38/358 (10.6%) admissions having a psychiatric diagnosis and 30/358 (8.4%) also having a fracture. This was compared with 473 referrals and 195 admissions (three/day) in the COVID period, with 73/195 (37.4%) admissions having a documented psychiatric diagnosis and 47/195 (24.1%) having a fracture.

DISCUSSION:

There was a reduction in the number of admissions and referrals during the pandemic, but a simultaneous three-fold rise in admissions with a psychiatric diagnosis. The proportion of patients with both a fracture and a psychiatric diagnosis more than doubled and the number of patients presenting due to a traumatic suicide attempt almost tripled.

CONCLUSION:

While total numbers using the orthopaedic service decreased, the impact of the pandemic and lockdown disproportionately affects those with mental health problems, a group already at higher risk of poorer functional outcomes and non-union. It is imperative that adequate support is in place for patients with vulnerable mental health during these periods, particularly as we look towards a potential 'second wave' of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Referral and Consultation / Suicide, Attempted / Fractures, Bone / COVID-19 / Hospitalization / Mental Disorders Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7026

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Referral and Consultation / Suicide, Attempted / Fractures, Bone / COVID-19 / Hospitalization / Mental Disorders Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7026