Riuttanen Antti, Ponkilainen Ville, Kuitunen Ilari, Reito Aleksi, Sirola Joonas, Mattila Ville M
Department of Orthopedics, Tampere University, Faculty of Medicine and Health Technology and Tampere University Hospital, Tampere.
Department of Surgery, Central Finland Hospital, Jyväskylä.
Acta Orthop. 2021 Jun;92(3):249-253. doi: 10.1080/17453674.2021.1881241. Epub 2021 Feb 4.
Background and purpose - COVID-19 lockdowns have resulted in noteworthy changes in trauma admissions. We report and compare the incidence and characteristics of severe injuries (New Injury Severity Score [NISS] > 15) during the COVID-19 lockdown in Finland with earlier years.Methods - We retrospectively analyzed incidence rate, injury severity scores, injury patterns, and mechanisms of injury of all severely injured patients (NISS >15) in 4 Finnish hospitals (Tampere University Hospital, Kuopio University Hospital, Central Finland Hospital, Mikkeli Central Hospital) during the 11-week lockdown period (March 16-May 31, 2020) with comparison with a matching time period in earlier years (2016-2018). These 4 hospitals have a combined catchment area of 1,150,000 people or roughly one-fifth of the population of Finland.Results - The incidence rate of severe injuries during the lockdown period was 4.9/10 inhabitants (95% CI 3.7-6.4). The incidence rate of severe injuries during years 2016-2018 was 5.1/10 inhabitants (CI 3.9-6.5). We could not detect a significant incidence difference between the lockdown period and the 3 previous years (incidence rate difference -0.2 (CI -2.0 to 1.7). The proportion of traffic-related accidents was 55% during the lockdown period and 51% during previous years. There were no detectable differences in injury patterns. During the lockdown period, the mean age of patients was higher (53 years vs. 47 years, p = 0.03) and the rate of severely injured elderly patients (aged 70 or more) was higher (30% vs. 16%).Interpretation - Despite heavy social restrictions, the incidence of severe injuries during the lockdown period was similar to previous years. Notably, a decline in road use and traffic volumes did not reduce the number of severe traffic accidents. Although our data is compatible with a decrease of 2.0 to an increase of 1.7 severely injured patients per 10 inhabitants, we conclude that severely injured patients do not disappear even during pandemic and stabile hospital resources are needed to treat these patients.
背景与目的——新冠疫情封锁措施导致创伤入院情况发生显著变化。我们报告并比较了芬兰新冠疫情封锁期间与前几年严重损伤（新损伤严重程度评分[NISS]＞15）的发生率及特征。
方法——我们回顾性分析了芬兰4家医院（坦佩雷大学医院、库奥皮奥大学医院、中芬兰医院、米凯利中心医院）在为期11周的封锁期（2020年3月16日至5月31日）内所有严重受伤患者（NISS＞15）的发生率、损伤严重程度评分、损伤模式及损伤机制，并与前几年（2016 - 2018年）的相匹配时间段进行比较。这4家医院的联合服务区域人口为115万，约占芬兰人口的五分之一。
结果——封锁期间严重损伤的发生率为每10名居民中有4.9例（95%置信区间3.7 - 6.4）。2016 - 2018年期间严重损伤的发生率为每10名居民中有5.1例（置信区间3.9 - 6.5）。我们未发现封锁期与前三年之间存在显著的发生率差异（发生率差值 -0.2（置信区间 -2.0至1.7））。封锁期间与交通相关事故的比例为55%，前几年为51%。损伤模式未发现可检测到的差异。封锁期间，患者的平均年龄更高（53岁对47岁，p = 0.03），严重受伤老年患者（70岁及以上）的比例更高（30%对16%）。
解读——尽管实施了严格的社会限制措施，但封锁期间严重损伤的发生率与前几年相似。值得注意的是，道路使用和交通流量的下降并未减少严重交通事故的数量。虽然我们的数据表明每10名居民中严重受伤患者数量的变化范围在减少2.0至增加1.7例之间，但我们得出结论，即使在疫情期间严重受伤患者也不会消失，需要稳定的医院资源来治疗这些患者。
