Highway Safety Research Center, University of North Carolina at Chapel Hill, 730 Martin Luther King Jr. Blvd., Suite 300, Chapel Hill, NC 27599-3430, USA.
Injury Prevention Research Center, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., Chapel Hill, NC 27599-7505, USA; Injury and Violence Prevention Branch, Division of Public Health, NC Department of Health and Human Services, 1915 Mail Service Center, Raleigh, NC 27699-1915, USA.
Am J Emerg Med. 2021 Sep;47:187-191. doi: 10.1016/j.ajem.2021.04.019. Epub 2021 Apr 20.
The global COVID-19 pandemic has had a major impact on the utilization of healthcare services; however, the impact on population-level emergency department (ED) utilization patterns for the treatment of acute injuries has not been fully characterized.
This study examined the frequency of North Carolina (NC) EDs visits for selected injury mechanisms during the first eleven months of the COVID-19 pandemic.
Data were obtained from the NC Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), NC's legislatively mandated statewide syndromic surveillance system for the years 2019 and 2020. Frequencies of January - November 2020 NC ED visits were compared to frequencies of 2019 visits for selected injury mechanisms, classified according to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) injury diagnosis and mechanism codes.
In 2020, the total number of injury-related visits declined by 19.5% (N = 651,158) as compared to 2019 (N = 809,095). Visits related to motor vehicle traffic crashes declined by a greater percentage (29%) and falls (19%) declined by a comparable percentage to total injury-related visits. Visits related to assault (15%) and self-harm (10%) declined by smaller percentages. Medication/drug overdose visits increased (10%), the only injury mechanism studied to increase during this period.
Both ED avoidance and decreased exposures may have contributed to these declines, creating implications for injury morbidity and mortality. Injury outcomes exacerbated by the pandemic should be addressed by timely public health responses.
全球 COVID-19 大流行对医疗服务的利用产生了重大影响；然而，对于急性损伤的人群急诊（ED）就诊模式的影响尚未完全阐明。
本研究调查了 COVID-19 大流行的前十一个月中，北卡罗来纳州（NC）ED 因特定损伤机制就诊的频率。
数据来自 NC 疾病事件跟踪和流行病学采集工具（NC DETECT），NC 立法规定的全州综合征监测系统，用于 2019 年和 2020 年。2020 年 1 月至 11 月 NC ED 就诊的频率与 2019 年因特定损伤机制就诊的频率进行比较，根据国际疾病分类，第 10 次修订版，临床修正（ICD-10-CM）损伤诊断和机制代码进行分类。
与 2019 年（809095 次）相比，2020 年与损伤相关的就诊总数下降了 19.5%（N = 651158）。与机动车交通碰撞相关的就诊减少了 29%，跌倒（19%）与总损伤相关就诊的减少幅度相当。与袭击（15%）和自我伤害（10%）相关的就诊减少幅度较小。药物/药物过量就诊增加了 10%，这是在此期间研究的唯一增加的损伤机制。
ED 回避和暴露减少都可能导致这些下降，这对伤害发病率和死亡率产生了影响。应通过及时的公共卫生应对措施来解决大流行加剧的伤害后果。
