The effect of the COVID-19 pandemic on mental health associated trauma, admissions and fractures at a London major trauma centre.
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 ANDMETHODS:
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.Keywords
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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