Department of Surgery, Crozer-Chester Medical Center, Upland, PA.
Department of Surgery, Crozer-Chester Medical Center, Upland, PA.
Surgery. 2022 Feb;171(2):533-540. doi: 10.1016/j.surg.2021.06.024. Epub 2021 Jun 23.
The coronavirus disease 2019 pandemic and associated policies have had important downstream consequences for individuals, communities, and the healthcare system, and they appear to have been accompanied by rising interpersonal violence. The objective of this study was to evaluate the incidence of injuries owing to interpersonal violence after implementation of a statewide stay-at-home order in Pennsylvania in March 2020.
Using the Pennsylvania Trauma Outcome Study registry, we conducted a retrospective cohort study of patients with gunshot wounds, stab wounds, and blunt assault-related injuries attributable to interpersonal violence treated at Pennsylvania trauma centers from March 16 to July 31 of 2018, 2019, and 2020.
There were fewer total trauma admissions in 2020 (17,489) vs 2018 (19,290) and 2019 (19,561). Gunshot wounds increased in 2020 to 737 vs 647 for 2019 and 565 for 2018 (P = .028), whereas blunt assault injuries decreased (P = .03). In all time periods, interpersonal violence primarily impacted urban counties. African American men were predominantly affected by gunshot wounds and stab wounds, whereas Caucasian men were predominantly affected by blunt assault injuries. There were more patients with substance abuse disorders and positive drug screens during coronavirus disease than in comparison periods: (stab wound population 52.3% vs 33.9% vs 45.9%, coronavirus disease era vs 2018 vs 2019, respectively P = .0001), (blunt assault injury population 41.4% vs 33.1% vs 33.5%, coronavirus disease era vs 2018 vs 2019, respectively P < .0001). There was no correlation between the incidence of interpersonal violence and coronavirus disease 2019 rates at the county level.
The implementation of a stay-at-home order was accompanied by rising incidence of gunshot and stab wound injuries in Pennsylvania. Preparedness for future resurgences of coronavirus disease 2019 and other pandemics calls for plans to address injury prevention, recidivism, and access to mental health and substance abuse prevention services.
2019 年冠状病毒病大流行及相关政策对个人、社区和医疗保健系统造成了重要的下游影响,且似乎还伴随着人际暴力的上升。本研究的目的是评估 2020 年 3 月宾夕法尼亚州实施全州居家令后,人际暴力所致伤害的发生率。
利用宾夕法尼亚创伤结局研究登记处,我们对 2018 年、2019 年和 2020 年 3 月 16 日至 7 月 31 日期间在宾夕法尼亚州创伤中心治疗的归因于人际暴力的枪伤、刺伤和钝器伤相关伤害的患者进行了回顾性队列研究。
2020 年总创伤入院人数(17489 人)少于 2018 年(19290 人)和 2019 年(19561 人)。2020 年枪伤增加至 737 例,高于 2019 年的 647 例和 2018 年的 565 例(P=0.028),而钝器伤减少(P=0.03)。在所有时间段内,人际暴力主要影响城市县。非裔美国男性主要受到枪伤和刺伤的影响,而白种男性主要受到钝器伤的影响。在冠状病毒病期间,与对照期相比,有更多的患者患有物质滥用障碍和药物筛查阳性:(刺伤人群 52.3%比 33.9%比 45.9%,冠状病毒病时期比 2018 年比 2019 年,分别 P=0.0001),(钝器伤人群 41.4%比 33.1%比 33.5%,冠状病毒病时期比 2018 年比 2019 年,分别 P<0.0001)。县一级人际暴力发生率与 2019 年冠状病毒病发病率之间没有相关性。
在宾夕法尼亚州实施居家令后,枪伤和刺伤的发生率上升。为应对 2019 年冠状病毒病和其他大流行的再次爆发,需要制定计划,以解决伤害预防、累犯和获得精神健康和物质滥用预防服务的问题。