Paiva Marcelo, Rao Vinay, Spake Carole S L, King Victor A, Crozier Joseph W, Liu Paul Y, Woo Albert S, Schmidt Scott T, Kalliainen Loree K
Division of Plastic Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Plast Reconstr Surg Glob Open. 2020 Dec 3;8(12):e3371. doi: 10.1097/GOX.0000000000003371. eCollection 2020 Dec.
Stay-at-Home (SAH) orders implemented in the United States to combat COVID-19 had a significant impact on health care delivery for patients with all conditions. In this study, we examined the effect SAH orders had on the Emergency Department (ED) consultation volume, injury patterns, and treatment of patients managed by our plastic surgery service.
In Rhode Island, SAH orders were instituted from March 28, 2020, to June 30, 2020. A retrospective chart review of patients presenting to our Level-1 academic medical center was performed. Patient demographics, types of injuries, and need for treatment in the ED or operating room (OR) were collected. Tests of significance were conducted using a comparison group spanning the same time period, in 2019.
There was a 36% decrease in ED consultations to plastic surgery during SAH orders when compared with those in 2019. No observed differences were noted in patient demographics between time periods. There were significant increases in the proportions of hand injuries secondary to power tools and facial injuries secondary to falls. No observed differences were identified in injury severity and need for either operating-room interventions or ED interventions for patients seen in consultation during SAH orders.
SAH orders resulted in a decreased volume of plastic surgery consults in the ED but did not alter patient demographics, injury severity, or need for procedural interventions. There was a 2.9% positivity rate for COVID-19 for asymptomatic patients presenting in the ED with primary hand and facial injuries.
美国为抗击新冠疫情实施的居家令对各类疾病患者的医疗服务产生了重大影响。在本研究中,我们调查了居家令对急诊科(ED)会诊量、损伤模式以及我们整形外科服务所管理患者的治疗情况的影响。
在罗德岛州,居家令于2020年3月28日至2020年6月30日实施。对前来我们一级学术医疗中心就诊的患者进行了回顾性病历审查。收集了患者的人口统计学信息、损伤类型以及在急诊科或手术室(OR)接受治疗的需求。使用2019年同一时间段的对照组进行显著性检验。
与2019年相比,居家令期间整形外科的急诊科会诊量下降了36%。不同时间段之间在患者人口统计学方面未观察到差异。电动工具导致的手部损伤和跌倒导致的面部损伤比例显著增加。在居家令期间会诊的患者中,在损伤严重程度以及手术室干预或急诊科干预需求方面未观察到差异。
居家令导致急诊科整形外科会诊量减少,但未改变患者人口统计学、损伤严重程度或程序性干预需求。在急诊科因原发性手部和面部损伤就诊的无症状患者中,新冠病毒检测阳性率为2.9%。